Possible transmission?

[Scared625]

Hi docs,  I went in on Monday to get an hiv test. after taking the test, the phlebotomist put a cotton ball on the puncture wound where they drew blood. She told me to put pressure on it. I looked at the cotton ball and saw that there was something that looked like blood on the top side. There was a gentleman who had his blood drawn just seconds before I did.  I freaked out And asked for another cotton ball. My blood started comin out pretty heavy from the puncture wound when I took the cotton ball off. My questions are:
1. Is this ANY risk of hiv transmission? Why or why not?
2. Has this EVER happened to anyone in the United States ever?
3.  Would a small drop of blood be enough to infect a deep puncture wound such as the draw site?
4.  Is this considered an environmental surface (cotton) pleas explain why or why not?
5.  The person in front of me left, and I sat, the phlebotomist can in, set up her stuff, drew my blood with two vails, and THEN put the cotton ball on. Would this have been enough time for the virus to become inactive?
6. If I want to test, when should I test with what type of test.?

[Edward W Hook, MD]

Brief answers.  I will not go into further detail regarding your choice to perform a needless test and the ask "what if" questions:

1. How long does the p r test usually take, I'm at kaiser?
The test itself takes 4-5 hours to perfrom but most labs only perform it a few days a week.  You need to ask the person who ordered it.

2. How accurate is kaiser for their RNA viral load?
I have no idea.  This test is NOT recommended for HIV diagnosis.  You probably read on the internet that this is afaster test and in some instnaces it is but it is still not recommended because of problems with false positves and other difficulties.


3. What are the chances these days that I get a false positive on this test? I am a numbers guy so I need probability?
Less than 1%, many times higher than your likelyhood of having acquired HIV.

4. If I get a positive on this test, which test would confirm it?
You would have to wait for an antibody test to also be positive.

This will end this thread.  EWH

[Scared625]

Ok doc, i know i had no risk whatsoever and this is a moot point, but just to put my mind at ease I went in and got an hiv rna pcr test. It's been killing me to wait for it. I have a couple of follow up questions on this.
1. How long does the p r test usually take, I'm at kaiser?
2. How accurate is kaiser for their RNA viral load?
3. What are the chances these days that I get a false positive on this test? I am a numbers guy so I need probability?
4. If I get a positive on this test, which test would confirm it?

[Edward W Hook, MD]

Welcome to our Forum.  We get many questions from clients who have concerns about getting infected during phlebotomy, often related to fears that a phlebotomist may have used contaminated equipment or transferred blood on their hands from one person to another. The short answer to these concerns is that phlebotomists are highly trained and highly regulated and there are NO instances in which HIV has been transmitted from person to person in the setting of medical phlebotomy- none at all.  I suspect that what you saw was not blood or was your blood.  I urge you not to worry or waste your time and money seeking testing.  In answer to your specific questions:

1. Is this ANY risk of hiv transmission? Why or why not?
No, none.  The reasons are too numerous to count and include the low likelihood that the person cared before you had HIV, that it is most unlikely that what you saw was someone else's blood, that cotton ball was on your skin surface, not deep in tissue where it needs to be to cause infection, that if present the virus would likely adhere to the cotton and that the virus begins to die and becomes infectious when exposed to the environment.

2. Has this EVER happened to anyone in the United States ever?
Not ever, and you are not going to be the first.

3.  Would a small drop of blood be enough to infect a deep puncture wound such as the draw site?
No, this is surface contamination.  the flow of blood was out- nothing was injected.

4.  Is this considered an environmental surface (cotton) pleas explain why or why not?
Yes,  It is NOT part of another human and did not enter your body.

5.  The person in front of me left, and I sat, the phlebotomist can in, set up her stuff, drew my blood with two vails, and THEN put the cotton ball on. Would this have been enough time for the virus to become inactive?
Yes- see above.

6. If I want to test, when should I test with what type of test.?
Testing is a waste of time and money.  You could just as productively burn your money.  If you must test, standard testing at standard times would be fine.  You can find these times using the search function on this site.

EWH