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Avatar universal

HIV from Transvaginal Ultrasound

Dear All,

I live in China. About two weeks ago, I went in to a Chinese hospital to get a transvaginal ultrasound, and I am very scared that I might have contracted HIV from this exposure.

I know that experts agree that transvaginal ultrasounds are not capable of infecting people with any kind of STD. However, at the hospital, women were being tested one after another in rapid succession.

Also, although I think the nurse placed a condom over the probe, I doubt she had enough time to thoroughly clean the probe in between insertions (although I am not sure if the woman who went before me even got a transvaginal ultrasound, because normal ultrasounds and transvaginal ultrasounds were performed in the same place)

IF the woman before me had HIV, and the probe was inserted with a condom, what are the chances that I am infected?
19 Responses
186166 tn?1385262982
Avatar universal
Because the condom would completely prevent transmission, right?
1448678 tn?1285483440
      The hospital veterans are fully aware of the risks associated with failing  to change the probe's condom. They maintain the level of hygine required for the patients to be safe.  Don't worry ...and don't let the HIV fear haunt ya...hmm

186166 tn?1385262982
you wouldnt get infected even if there was not a condom used on the probe ! !
1448678 tn?1285483440
   TThe riskS as i said ..which doesn't mean only HIV...If there was no risk the hospital people won't use the condoms...

   The point here was you dopn't need to worry about catching infections from such procedures...
186166 tn?1385262982
" TThe riskS as i said ..which doesn't mean only HIV...If there was no risk the hospital people won't use the condoms..."

THIS forum is hiv specific.

in regards to HIV...there was no risk, period...with or without a condom.
Avatar universal
Sorry it is possible even if the risk is indeed very low because of the use of a disinfecting wipe and a condom. But the risk exists since studies show that condom + wipes is not sufficient. That is why the CDC, the FDA, the AIUM, etc. insist that you must do a [HLD] High-Level Disinfection (chemical soaking) of these probes between patients even if you are using a probe cover. The AIUM does not give you accreditation if you do not perform HLD. Recently the VA stopped a service of imagery and cancelled all the appointments because they discovered that condom + wipes were performed instead of condom + HLD (the service resumed when the HLD resumed). A lot of papers exist on that matter, here are some of them (if you do not want to read papers there is also a book written by a regular guy, meaning that it is far from being scientifically perfect, it is called Fatal Probe) :

Possible HIV Transmission Associated with a Transrectal Ultrasound (TRUS)

Transvaginal transducer hygiene – what is the big deal?

Nosocomial Outbreak of Klebsiella pneumoniae Producing SHV-5 Extended-Spectrum β-Lactamase, Originating from a Contaminated Ultrasonography Coupling Gel

Evaluation of Ultraviolet C for Disinfection of Endocavitary Ultrasound Transducers Persistently Contaminated Despite Probe Covers

Ineffectiveness of latex condoms in preventing contamination of the transvaginal ultrasound transducer head

Just to tell you that people think condom are 100% efficient which is not true (see the CDC articles on condom) : it is a political statement so that people might use condom more often (because condom IS the best protection and is very useful). And also sonographers do not want to perform chemical soaking since it is a hard and heavy process.
186166 tn?1385262982
in regards to HIV...since this forum is hiv specific...there was NO risk.  once exposed to air...hiv becomes inactive and unable to infect.

DR HOOK / MEDHELP regarding transvaginal ultrasound:
"Finally, in addition to the standard precautions that I mention above, I should also point out that HIV is not transmitted on inanimate object. the virus is very susceptible to drying and to the effects of environmental exposure."  

Avatar universal
Here are some extracts of scientific publications concerning vaginal and rectal ultrasound probes, you can see that it is relevant concerning the topic and that hygiene specialists consider it possible to transmit HIV with such instruments.

107 Possible HIV Transmission Associated with a Transrectal Ultrasound (TRUS) Prostate Biopsy Rachel L. Stricof, MPH, Perry F. Smith, MD, Lou Smith, MD.
New York State Department of Health, Albany, NY, USA.
Background: The New York State Department of Health was notified of an acute case of HIV infection with no identified risk factors.
Objectives: To identify the source and mode of HIV transmission.
Methods: Case study, contact evaluation, and infection control assessment of recent healthcare interventions.
Results: The New York State Department of Health (NYSDOH) investigated a case of possible HIV transmission associated with a transrectal ultrasound (TRUS) prostate biopsy. Incident HIV infection was detected during autologous cytapheresis donations for a surgical procedure. At the time of initial cytapheresis, the patient tested HIV negative by enzyme immunoassay (EIA), p24 antigen, and nucleic acid amplification testing (NAT). The p24 antigen was positive at the time of his second autologous donation one week later, and he later tested positive for HIV-1 antibody by EIA and Western Blot tests. On repeated interviews, the patient denied all HIV risk factors. The procedures at the blood center were reviewed and found to be in compliance with appropriate infection control guidelines, and all other donors within a 10 day period were HIV negative. The only recent medical or dental procedure was a TRUS prostate biopsy performed 63 days prior to the p24- positive donation. The prostate biopsy had been performed in a private urology practice setting. A review of the prostate biopsy procedures revealed that “single use only” needle guides had been reused between patients. At the time, the needle guides were reprocessed by injecting (flushing) with gluteraldehyde and soaking in a basin of gluteraldehyde. There was no evidence that the device had been brushed, that the internal lumen of the needle guide had sufficient contact time with the disinfectant or that the concentration of the disinfectant was being monitored and maintained. The NYSDOH attempted to identify a source patient with HIV and any additional suspected cases of HIV transmission by sending a letter of notification with recommendations for HIV testing to 40 patients who underwent prostate biopsies in the same setting in the same time period. Of the 32 individuals who underwent HIV testing or reported results, all reported HIV negative results.
Conclusion: No patient source of infection was identified although HIV test results were not reported for all patients preceding the incident HIV case. The investigation was ultimately inconclusive and transmission via the prostate biopsy procedure could not be confirmed.

"Contaminated medical equipment certainly is a possible mechanism for horizontal transmission of infection such as viral hepatitis, HIV infection, gonorrhea, chlamydia, and trichomoniasis." Sheathing of the Endovaginal Ultrasound Probe: Is It Adequate? ; Ronald Jimenez and Patrick Duff Division of Maternal-Fetal Medicine, University ofFlorida College ofMedicine, Gainesville, FL

"Contaminated medical equipment is a possible mechanism for horizontal transmission of viral hep- atitis, HIV, and sexually transmitted diseases such as gonorrhea and chlamydia." High Rates of Perforation Are Found in Endovaginal Ultrasound Probe Covers Before and After Oocyte Retrieval for in Vitro Fertilization-Embryo Transfer ; MICHAEL HIGNETT, and PAUL CLAMAN

"We have demonstrated a significant condom perforation rate (9%) amongst patients undergoing prostate biopsies. This raises the serious issue of hygiene and cross-infection, particularly with blood-borne com- municable diseases such as hepatitis and HIV unless strict disinfection and sterilization protocols are followed between patients. Although the risk of cross-infection is probably small this serious issue needs to be addressed." Condom perforation during transrectal ultrasound guided (TRUS) prostate biopsies: a potential infection risk ; Junaid Masood

186166 tn?1385262982
no reason for me to read all of that when the FACT of the matter is:

hiv becomes inactive once exposed to air
hiv is not transmitted through inanimate objects

in regards to hiv transmission...THERE IS NO RISK
Avatar universal
As you have been advised you were never at risk of contracting HIV from a transvaginal ultrasound.
Avatar universal
You should read scientific publications it never hurts to know...
The risk is very very low but it exists : 2 quotations from the CDC (one concerning the fact that HIV does not last long outside the host, and the second one about the fact that HIV transmissions are very rare but have occurred in healthcare settings, notably in dental care, if the proper disinfection is not performed) :

"Scientists and medical authorities agree that HIV does not survive well outside the body, making the possibility of environmental transmission remote. HIV is found in varying concentrations or amounts in blood, semen, vaginal fluid, breast milk, saliva, and tears. To obtain data on the survival of HIV, laboratory studies have required the use of artificially high concentrations of laboratory-grown virus. Although these unnatural concentrations of HIV can be kept alive for days or even weeks under precisely controlled and limited laboratory conditions, CDC studies have shown that drying of even these high concentrations of HIV reduces the amount of infectious virus by 90 to 99 percent within several hours. Since the HIV concentrations used in laboratory studies are much higher than those actually found in blood or other specimens, drying of HIV-infected human blood or other body fluids reduces the theoretical risk of environmental transmission to that which has been observed–essentially zero. Incorrect interpretations of conclusions drawn from laboratory studies have in some instances caused unnecessary alarm.

Results from laboratory studies should not be used to assess specific personal risk of infection because (1) the amount of virus studied is not found in human specimens or elsewhere in nature, and (2) no one has been identified as infected with HIV due to contact with an environmental surface. Additionally, HIV is unable to reproduce outside its living host (unlike many bacteria or fungi, which may do so under suitable conditions), except under laboratory conditions; therefore, it does not spread or maintain infectiousness outside its host."

"Although HIV transmission is possible in health care settings, it is extremely rare. Medical experts emphasize that the careful practice of infection control procedures, including universal precautions (i.e., using protective practices and personal protective equipment to prevent HIV and other blood-borne infections), protects patients as well as health care providers from possible HIV transmission in medical and dental offices and hospitals.

For more information on preventing occupational exposure to HIV, refer to the CDC fact sheet, “Preventing Occupational HIV Transmission to Healthcare Personnel.”

In 1990, the CDC reported on an HIV-infected dentist in Florida who apparently infected some of his patients while doing dental work. Studies of viral DNA sequences linked the dentist to six of his patients who were also HIV-infected. The CDC has not yet been able to establish how the transmission took place. No additional studies have found any evidence of transmission from provider to patient in health care settings.

CDC has documented rare cases of patients contracting HIV in health care settings from infected donor tissue. Most of these cases occurred due to failures in following universal precautions and infection control guidelines. Most also occurred early in the HIV epidemic, before established screening procedures were in place."

And of course, it's a tad short to claim "there is not risk from vaginal ultrasound" since the experts on vaginal-rectal ultrasound probe hygiene state different... Just check the facts on this very rich topic...
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