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Avatar universal

HIV test

Hi, I am a nurse who was stuck by a needle on December 10, 2008. I showed it to my manager and she basically disregarded my stick as a stick because we didnt see any blood and was told not to report it to employee health. Well the pas week I have had a sore throat that lasted for two days, a low grade fever of 99.3, slight headache, and swollen lymph nodes in the neck, one small one in the right armpit and maybe a small one in the groin that i found yesterday. Well i went to several doc and they too disregarded me. I did my baseline testing and it was negative. Yesterday, one day away from being five weeks (34 days) i did another test and that too was negative.

my question is how reassuring is this test and what statistics do you have regarding accuracy of a HIV test at 34 days post exposure. Also should i be considered about the swollen lymph node in the armpit (its only one on the right side that occasionally becomes reactive every couple of months) and the small one on the right groin (another node that i too have to fish around and find)- basically the nodes on the neck arent too swollen either bc the PA states that they are slightly swollen and that if she fishes around too, she will find one node larger than another- is that true? Please help me i worried sick out of my mind
11 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
I'll try to help.  The bottom line is that you describe an exposure that most likely was very low risk, pehaps zero.  Interestingly, you don't say the HIV status of the patient on whom the needle was used.  Perhaps you don't know; the normal procedure (at least in the US) is to test the patient in this circustances, in which case you would know for sure whether or not you were potentially exposed.  However, your manager is basically correct:  to my knowledge there has never been an HIV transmission by sharp instrument if the injury did not draw blood.  In fact, most of them are rather substantial injuries, such as deep wounds with large-bore (e.g., 18 guauge) needles that contained visible blood, or a slash with a bloody scalpel.  (Maybe that's why the patient wasn't tested -- insufficient exposure to justify asking him or her to undergo HIV testing.)

To the question about testing, with modern HIV antibody tests, probably around 95% of newly infected persons have positive test results at 5 weeks (35 days).  Finally, your symptoms do not suggest HIV.  Early HIV infection doesn't cause just one or two lymph nodes to be so little enlarged that you have to poke around to find them; and early HIV infection almost always causes substantial fever.  (Think of it as infectious mononucleosis; it's essentially the same illness, as far as symptoms and physical exam are concerned.)

In summary:  Probably your manager is correct and there was no HIV risk, even if you assume the needle had been used on an HIV infected patient.  In any case, the negative blood test results sare strong evidence you weren't infected.  To ice the cake and be even more certain, you could have a final HIV test after 8 weeks -- or, to be consistent with many published guidelines, 3 months after the event.  (Although it rarely is actually necessary to wait that long -- scan this forum for innumerable discussions about the timing of HIV test results.)

In the meantime, try not to worry about this.  You aren't infected.

Best wishes--- HHH, MD
Avatar universal
Also, I am on birth control and have periods like clockwork. I also did not get my period this month either and there is zero possiblity of me being prenant. Is this also a possible symptom of HIV seroconversion. Sorry for the questions but I figure if i spent 15 dollars i should be able to get some anxiety relief and I am very stressed out.
239123 tn?1267647614
MEDICAL PROFESSIONAL
HIV doesn't cause altered menstrual cycles, to my knowlege.  This doesn't change my opinion and advice above.
Avatar universal
I dont know the HIV status of the patient and I was hoping we could test the pt but my manager didnt deem it neccesary. Also i used a 22g needle and there was a flash of the pts blood so the needle was dirty and exposed to the pts blood. it was stuck into his vein.  you state the at 35 days 95% of the people would show positive but i tested at 34 days. Does one day make a huge difference in my result reliability. thanks this should be my final question
Avatar universal
also my glove did have a little hole in it if that makes any difference.
Avatar universal
my 34 day test was using the oraquick advance. how reliable is that particular test at 34 days or would you suggest i do the traditional blood test. Thanks. to me i feel that the nodes a substantially swollen if that makes any difference. the ones in the throat can be easily felt where as the one in the armpit and groin is smaller.
239123 tn?1267647614
MEDICAL PROFESSIONAL
The additional information doesn't change my opinion or advice.  The Oraquick Advance is top-of-the-line.  Try to relax about this. You weren't infected.
Avatar universal
thanks for all your help. Due to your expertise in infectous diseases, i do believe i can relax much more now. Have a good day and thank you for all you do.
Avatar universal
I do have one more question. I just got my blood work back from the doctor and he says my potassium is low. Does that have anything to do with seroconversion and exposure to HIV? Basically does that mean that I am seroconverting.
239123 tn?1267647614
MEDICAL PROFESSIONAL
Oh good grief.  When people get test results back, the person to ask about them is the doctor who did the test!  An online forum isn't a substitute for proper medical care.

The answer is no.

That is all for this thread, period.
Avatar universal
He said no as well but I wanted a second opinion from an expert in infectous disease and HIV.
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