HIV needle stick infection rate

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Discussion Overview

The discussion revolves around the risk of HIV transmission following a needle stick injury from a syringe used on an HIV-positive patient. Participants explore the likelihood of infection, the effectiveness of post-exposure prophylaxis (PEP), and the timing of HIV testing.

Discussion Character

  • Exploratory
  • Technical explanation
  • Debate/contested

Main Points Raised

  • One participant mentions that the average rate of HIV infection from a needle stick injury is approximately 0.3%, citing statistics for comparison with other viruses like HBV and HCV.
  • Another participant confirms the abbreviations for hepatitis viruses and clarifies that HIV stands for Human Immunodeficiency Virus.
  • There is a suggestion that there are drugs available that can significantly reduce the risk of infection if taken within a certain time frame after exposure.
  • A participant describes their understanding that a drug regimen can make a person feel very ill but is effective in preventing infection.
  • Another participant provides a range of estimates for the chance of acquiring HIV from the needle stick, noting that these can vary based on several factors, including the volume of blood and the nature of the injury.
  • Discussion includes details about the recommended post-exposure prophylaxis regimen, mentioning AZT and lamivudine, and the timing for initiating PEP.
  • There are recommendations for follow-up testing intervals for HIV after exposure, with some uncertainty about the latest time frame for effective PEP.

Areas of Agreement / Disagreement

Participants express varying views on the likelihood of HIV transmission and the effectiveness of PEP, indicating that multiple competing perspectives exist regarding the risk factors and treatment protocols.

Contextual Notes

Participants note that the risk of infection can depend on various factors, including the nature of the needle stick injury and the health status of the source patient. There is also mention of differing opinions on the timing for effective PEP.

Monique
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A friend of my mother is a caretaker and accidentially stuck herself in the finger with a needle used on an HIV patient. It probably won't be until 6 mo from now until it can be diagnosed whether an infection has taken place.

I was wondering, what are the chances that HIV is contracted and is anti-viral therapy post-exposure a thing to do?
 
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Does this make sense?

Back to the statistics: the average rate of infection for the three viruses after a NSI from a syringe containing fresh blood from a known infected source is up to 30% for HBV, 3-5% for HCV and 0.3% for HIV.
http://archive.mail-list.com/hbv_research/msg01985.html
 
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HBV and HCV are hep b and c, respectively?
 
Hepatitis B Virus and Hepatitis C Virus, yup :)
HIV = Human Immunodeficiency Virus
 
Aren't there drugs available to those that have been exposed in a 12-24 hour time-frame that dramatically lowers the odds of being infected?
 
I was under the same impression, a drug is given immediately which makes the person extremely sick for a couple of days, but it prevents the infection.

nautica
 
Depending on who you ask she has a .3% or 1.5% chance of acquiring aids from the needle stick but you can reduce those chances a further 80% by taking AZT for four weeks after exposure. However, with the AZT resistance rate and if the person is already on AZT for 6 months, the new recommendation is now AZT and lamivudine for post exposre prophylaxis. (PEP)


Risk is higher if there is a large volume of blood,
If the injury is deep,
If the instrument is of a hollow bore nature (e.g. syringe needle) and was previously in the source patient's vein or artery,
If the blood is actually injected,
If the source patient has clinical AIDS, or
A low CD4 cell count and/or
A high HIV RNA viral load (titre).



PEP is initiated within hours after the exposure. (This is what I did for myself as an Intern 10 years ago and I am still HIV neg after alll these years) The interval after which there is no benefit from using PEP is not yet defined, however some ID (infectious disease) folks consider 24–36 hours as being too late. Some infectious disease specialists still consider PEP 7–14 days after the exposure in cases where there is highest risk exposures.



An ELISA HIV test should be done and documented on the exposed health care worker at baseline (i.e. within 24 hours of the injury), at 6 weeks, 12 weeks and at 6 months. (In rarer instances seroconversion can take place over a longer period than 6 months).

.
 
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