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Confused about transmission through skin
Hello doctors,
I have a couple of questions regarding transmission of HIV through blood on the skin. There is a lot of information on the internet that suggests a person can contract HIV if an infected persons fresh blood gets on their skin that has a cut, abrasion, inflammation, dry skin, rash, eczema etc. My first question is: What needs to be present in order for HIV infection to be transmitted through the skin (in other words what constitutes as non-intact skin for transmission to occur)?
Scenario: If a health care worker has a small spot (3cm x 3cm) of eczema or type or dermatitis rash on their arm that is not open, and is almost "healed" and they remove a cathlon or needle from a patients arm and a small amount of blood (< 0.5ml) splashes directly onto their arm where the healing rash is located and is present from approx. 1-2 minutes is there risk for transmission if the person was HIV+?
Thanks for your time.
I have a couple of questions regarding transmission of HIV through blood on the skin. There is a lot of information on the internet that suggests a person can contract HIV if an infected persons fresh blood gets on their skin that has a cut, abrasion, inflammation, dry skin, rash, eczema etc. My first question is: What needs to be present in order for HIV infection to be transmitted through the skin (in other words what constitutes as non-intact skin for transmission to occur)?
Scenario: If a health care worker has a small spot (3cm x 3cm) of eczema or type or dermatitis rash on their arm that is not open, and is almost "healed" and they remove a cathlon or needle from a patients arm and a small amount of blood (< 0.5ml) splashes directly onto their arm where the healing rash is located and is present from approx. 1-2 minutes is there risk for transmission if the person was HIV+?
Thanks for your time.
MEDICAL PROFESSIONAL
Welcome to the forum.
The information you have found -- "information on the internet that suggests a person can contract HIV if an infected persons fresh blood gets on their skin that has a cut, abrasion, inflammation, dry skin, rash, eczema etc" -- is theoretical only. To my knowledge, there has never been an actual case of such transmission.
Because there have been no known cases of such transmission, it isn't possible to give a clear answer to "what needs to be present" to allow such transmission. My guess is that it would require known HIV contaminated blood in prolonged contact, perhaps being rubbed or abraded into the skin. Also, the person with HIV would have to have a high viral load, not be on HIV treatment, etc.
Therefore, I would conclude that there is little if any risk from the sort of exposure you describe. That said, if this really happened, and assuming you are the health care worker involved, you should tell your supervisor -- or whoever is in charge of infection control in the office, clinic, or hospital where it happened -- then follow their advice. If the exposure is considered by them to be substantial, and if the patient's HIV status isn't known, the patient could be tested; or if known positive, the viral load determined. In addition, the infection control folks may want to analyze the incident to determine whether it was potentially risky and, if so, to see what training or changes in procedure might be recommended to prevent a recurrence.
So do what's right and let people know. But in the meantime, don't be worried. This sounds like an extremely low risk event, probably no risk at all.
Best wishes-- HHH, MD
The information you have found -- "information on the internet that suggests a person can contract HIV if an infected persons fresh blood gets on their skin that has a cut, abrasion, inflammation, dry skin, rash, eczema etc" -- is theoretical only. To my knowledge, there has never been an actual case of such transmission.
Because there have been no known cases of such transmission, it isn't possible to give a clear answer to "what needs to be present" to allow such transmission. My guess is that it would require known HIV contaminated blood in prolonged contact, perhaps being rubbed or abraded into the skin. Also, the person with HIV would have to have a high viral load, not be on HIV treatment, etc.
Therefore, I would conclude that there is little if any risk from the sort of exposure you describe. That said, if this really happened, and assuming you are the health care worker involved, you should tell your supervisor -- or whoever is in charge of infection control in the office, clinic, or hospital where it happened -- then follow their advice. If the exposure is considered by them to be substantial, and if the patient's HIV status isn't known, the patient could be tested; or if known positive, the viral load determined. In addition, the infection control folks may want to analyze the incident to determine whether it was potentially risky and, if so, to see what training or changes in procedure might be recommended to prevent a recurrence.
So do what's right and let people know. But in the meantime, don't be worried. This sounds like an extremely low risk event, probably no risk at all.
Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
I'm glad to have helped. Thanks for the clarification.
Thank-you for your quick and informative response. The scenario was just a "what if" type of scenario in order to get a better understanding of transmission through the skin in health care type settings.
Thanks again.
Thanks again.
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