Aa
ocd, blood exposure
I would just like to share my story here as I wonder if there are others like me. I have been suffering from severe hiv anxiety for the past 2 years.A few years ago I put myself in some high risk scenarios and just before getting married, began to fret over the consequences. Since then over the last 3 years, I have gone for countless hiv tests over things such as razor nicks etc... every test has come back negative. Last year, my husband got into a scuffle and scraped his knuckle slightly against another man's teeth. After that incident, I myself have had at least 4 negative hiv tests ! (we have unprotected sex) n I have been trolling through all websites and forums (have even posted before) and seen people saying that it would need a lot of blood for transmission to take place. However, there is always that slight naggin feelin at the back of my mind. I am aware of my ocd and have spoken to a therapist several times over the past yr. Just when I thought I have put my fears to rest, the incident (from last yr) crops up in my mind again . I am so tired. I hope someone with similar experiences can share with me or help me with my anxiety. I just want it to stop.
sorry for my incessant questioning, but what abt this report? pls help me to put this into perspective...
Awareness of the risk of occupational transmission of HIV to health care workers dates back to December 1984, when the first case of needlestick-transmitted HIV infection was reported [1]. From December 1984 through September 1997, a total of 94 documented cases and 170 possible cases of occupational transmission of HIV to health care workers were reported worldwide. However, individuals with other types of jobs also risk occupational exposure to bloodborne infection. We report the case of a policeman in whom both HIV and hepatitis C virus (HCV) seroconversion were clearly documented after he was involved in a bloody fight while making an arrest.
A 52-year-old policeman (patient A) presented with a positive HIV result on EIA. Ten weeks previously, he had developed an acute mononucleosis-like syndrome. Acute HIV-1 infection was confirmed by means of gradual Western blot positivity. His CD4+ lymphocyte count was 399 × 109 cells/L, and his plasma level of HIV type 1 (HIV-1) RNA was 503,200 copies/mL. Alanine aminotransferase activity was slightly elevated. No antibodies to HCV were detected, and the patient was immune to hepatitis B virus (HBV). Three weeks later, HCV seroconversion was diagnosed (by means of EIA, recombinant immunoblot assay, and plasma HCV RNA positivity). The patient's sex partner was seronegative for both viruses, and the patient denied having had another sex partner during the previous 6 months. He had never received blood transfusions and had never been an injection drug user. However, he disclosed that, 3 weeks before the onset of his illness, he had punched a man in the teeth while making an arrest. Although he had noticed 2 wounds on his hand, which was covered with blood, he did not wash his hand immediately after the incident. Within a few days after the arrest, he developed lymphangitis that required antibiotic treatment.
The man who received the punch (patient B) was known to be infected with HIV-1, human T lymphotropic virus type 1 (HTLV-1), HBV, and HCV, but patient B declined all treatment. Six months after the incident, patient B's CD4+ lymphocyte count was 552 × 109 cells/L, his plasma level of HIV-1 RNA was 52,900 copies/mL, and his plasma level of HCV RNA (Amplicor HCV Monitor; Roche Diagnostics, Branchburg, NJ) was 132,052 copies/mL.
The strains of HIV and HCV that infected the 2 patients were compared. Viruses were isolated from the plasma of patient A at 4 months after the incident and from patient B at 6 months after the incident. Both HCV strains were determined to be genotype 2a. Nucleotide sequencing of the amplification product of the V3 region of HIV and the NS5b region of HCV revealed, respectively, 98.7% and 100% identity for the strains infecting the 2 patients. Fifteen months after the fight, the serological results of HTLV-1 testing were still negative.
Simultaneous transmission of either HIV and HCV or HIV and HBV from a single source has been previously described [2, 3]; however, to our knowledge, this is the first proven case of HIV-HCV coinfection that occurred as the result of a blow with the fist. Although HIV is probably infrequently transmitted via this route, this case raises the question of whether prophylaxis should be used after potential exposure to HIV during a bloody fight with an HIV-infected (or possibly HIV-infected) individual, as is recommended after other types of potential exposure to HIV, especially among individuals with frequent occupational exposure to HIV (e.g., police and fire department employees, etc.) [4]. Similarly, the risk of transmission of HCV infection during violent incidents should be taken into account.
References
1. Ippolito G, Puro V, Heptonstall J, Jagger J, De Carli G, Petrosillo N. Occupational human immunodeficiency virus infection in health care workers: worldwide cases through September 1997. Clin Infect Dis 1999; 28:36583. First citation in article | PubMed
2. Ridson R, Gallagher K, Ciesielski C, et al. Simultaneous transmission of human immunodeficiency virus and hepatitis C virus from a needle-stick injury. N Engl J Med 1997; 336:91922. First citation in article | PubMed
3. Brambilla A, Pristera R, Salvatori F, Poli G, Vicensi E. Transmission of HIV-1 and HCV by head-butting. Lancet 1997; 350:1370. First citation in article | PubMed
4. Lurie P, Miller S, Hecht F, Chesney M, Lo B. Postexposure prophylaxis after nonoccupational HIV exposure. JAMA 1998; 280:176973. First citation in article | PubMed
Awareness of the risk of occupational transmission of HIV to health care workers dates back to December 1984, when the first case of needlestick-transmitted HIV infection was reported [1]. From December 1984 through September 1997, a total of 94 documented cases and 170 possible cases of occupational transmission of HIV to health care workers were reported worldwide. However, individuals with other types of jobs also risk occupational exposure to bloodborne infection. We report the case of a policeman in whom both HIV and hepatitis C virus (HCV) seroconversion were clearly documented after he was involved in a bloody fight while making an arrest.
A 52-year-old policeman (patient A) presented with a positive HIV result on EIA. Ten weeks previously, he had developed an acute mononucleosis-like syndrome. Acute HIV-1 infection was confirmed by means of gradual Western blot positivity. His CD4+ lymphocyte count was 399 × 109 cells/L, and his plasma level of HIV type 1 (HIV-1) RNA was 503,200 copies/mL. Alanine aminotransferase activity was slightly elevated. No antibodies to HCV were detected, and the patient was immune to hepatitis B virus (HBV). Three weeks later, HCV seroconversion was diagnosed (by means of EIA, recombinant immunoblot assay, and plasma HCV RNA positivity). The patient's sex partner was seronegative for both viruses, and the patient denied having had another sex partner during the previous 6 months. He had never received blood transfusions and had never been an injection drug user. However, he disclosed that, 3 weeks before the onset of his illness, he had punched a man in the teeth while making an arrest. Although he had noticed 2 wounds on his hand, which was covered with blood, he did not wash his hand immediately after the incident. Within a few days after the arrest, he developed lymphangitis that required antibiotic treatment.
The man who received the punch (patient B) was known to be infected with HIV-1, human T lymphotropic virus type 1 (HTLV-1), HBV, and HCV, but patient B declined all treatment. Six months after the incident, patient B's CD4+ lymphocyte count was 552 × 109 cells/L, his plasma level of HIV-1 RNA was 52,900 copies/mL, and his plasma level of HCV RNA (Amplicor HCV Monitor; Roche Diagnostics, Branchburg, NJ) was 132,052 copies/mL.
The strains of HIV and HCV that infected the 2 patients were compared. Viruses were isolated from the plasma of patient A at 4 months after the incident and from patient B at 6 months after the incident. Both HCV strains were determined to be genotype 2a. Nucleotide sequencing of the amplification product of the V3 region of HIV and the NS5b region of HCV revealed, respectively, 98.7% and 100% identity for the strains infecting the 2 patients. Fifteen months after the fight, the serological results of HTLV-1 testing were still negative.
Simultaneous transmission of either HIV and HCV or HIV and HBV from a single source has been previously described [2, 3]; however, to our knowledge, this is the first proven case of HIV-HCV coinfection that occurred as the result of a blow with the fist. Although HIV is probably infrequently transmitted via this route, this case raises the question of whether prophylaxis should be used after potential exposure to HIV during a bloody fight with an HIV-infected (or possibly HIV-infected) individual, as is recommended after other types of potential exposure to HIV, especially among individuals with frequent occupational exposure to HIV (e.g., police and fire department employees, etc.) [4]. Similarly, the risk of transmission of HCV infection during violent incidents should be taken into account.
References
1. Ippolito G, Puro V, Heptonstall J, Jagger J, De Carli G, Petrosillo N. Occupational human immunodeficiency virus infection in health care workers: worldwide cases through September 1997. Clin Infect Dis 1999; 28:36583. First citation in article | PubMed
2. Ridson R, Gallagher K, Ciesielski C, et al. Simultaneous transmission of human immunodeficiency virus and hepatitis C virus from a needle-stick injury. N Engl J Med 1997; 336:91922. First citation in article | PubMed
3. Brambilla A, Pristera R, Salvatori F, Poli G, Vicensi E. Transmission of HIV-1 and HCV by head-butting. Lancet 1997; 350:1370. First citation in article | PubMed
4. Lurie P, Miller S, Hecht F, Chesney M, Lo B. Postexposure prophylaxis after nonoccupational HIV exposure. JAMA 1998; 280:176973. First citation in article | PubMed
because my husband scraped his knuckle, n there was a small cut.. pls help.. im really confused
sorry Lizzie, I just would like to know if my husband had a risk if the man had bled slightly onto my husband's scraped skin? pls help, i've heard of pple getting hiv from such wounds
thank u so much Lizzie for takin the time to answer my question... its time for me to lay my ocd to rest!
I would like to know if myhusband has had a risk when he scraped his knuckle against the other man's teeth. Although we dont think he (the man) bled, the thought really scares me.
the purpose of this forum:
If you believe you have been exposed to HIV and want help to judge your risk, would like advice about HIV testing, or have questions about the effectiveness of condoms or risks associated with specific sexual practices, this is the site for you.
If you believe you have been exposed to HIV and want help to judge your risk, would like advice about HIV testing, or have questions about the effectiveness of condoms or risks associated with specific sexual practices, this is the site for you.
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