Cuts and HIV

[Freeborn1970]

I was starting an IV at work and I took off my gloves to put on the dressing. I know it wasn't very smart on my part. When I went to wash my hands, I noticed a small amount of blood on my finger on the skin on side of nail and nail itself. I had a torn cuticle. I had no bleeding. I sometimes pick at the skin around my nails, but I did not see any open wounds. At 13 days i started to have swollen lymph nodes jaw area and canker sores on right side of mouth. These symptoms lasted 5 days. I had a HIV test at 2 weeks and 4 weeks, both negative. Now I have a small white spot on back of left tonsil. I'm really worried because I am breastfeeding. Does it have to be an open bleeding wound for there to be a risk? What about small cuts, tears in skin with no bleeding? Is a 4 week test reliable?

[Edward W Hook, MD]

I understand how when our children are concerned, everything is a bit more worrisome.  I'm pleased I could help.  EWH

[Freeborn1970]

Thank you so much. I appreciate you answering my questions. I just was worried about my baby and I didn't want to hurt her. I didn't report it right away like I should have, but then I became ill and of course I googled and worked myself into a frenzy. Then I told my employee health nurse and we did the testing, but the patient was already gone. I now know better. I have just been wrought with anxiety over hurting my baby. This is my first time to ever breastfeed and I did not want to have to stop. Its hard to explain. My employee health nurse said that I didn't even meet criteria for PEP so it wasn't an option. Thank you again for your knowledge and patience in answering my question.

[Edward W Hook, MD]

Welcome to our Forum.  I'll be happy to comment on your concerns. Let me first assure you that your swollen lymph nodes were not due to HIV.  If you had HIV which caused your lymph node swelling, your blood test for HIV would have been positive at that time. thus you can be sure that your swollen lymph nodes are not due to HIV.

More importantly however, the exposure you describe did not put you at risk for HIV.  I say this for a number of reasons.  These include:
1.  It is unlikely that the patient whose blood got on you had HIV (I would have thought you would have checked this).

2.  The sort of surface contamination you describe is not a serious exposure which is likely to transmit infection, even if you had cuts and irritation on your cuticles.

3.  At 4 weeks an HIV test would have detected over 90% of recent infections.  Thus your negative 4 week test is strong evidence that you are not infected.

My advice isfor you to not worry about this exposure.  There is no reason for you to worry about breast feeding your child.  In the future however, you should keep your gloves on.  Further, should such exposures occur, it is appropriate to report then to yoru occupational health office.  I hope this count helps.  EWH