Moderately low risk needlestick-for Ann

[scareddad]

8 weeks ago my 3 year old daughter picked up a discarded Novafine insulin pen needle off the floor of a hotel elevator and poked herself drawing blood from the tip of her finger. The needle was capped and the part she stuck herself with was the bottom portion where the needle enters the pen device, not where it enters the skin, although it is a single 30 gauge hollow bore from what I found on the internet. At 24 days post needlestick, she had an HCV RNA PCR <50 copies and an HIV RNA PCR <400 copies performed. Both came out negative. At 6 weeks she developed a rash on one face cheek and shoulder which went away in about 3-4 days. At 8 weeks she has now gotten a red slightly raised spot type rash in the crease of her elbow about the size of a 50 cent piece which went away in 2 days. Neither of them ever itched and she has had no other symptoms such as fever or lymph node swelling. My questions are: 1. How reliable are the 2 PCR's at 24 days? 2. Is there any chance that the rashes are a result of the needlestick (ie HCV or HIV)? 3. 4. What is the risk from this type of exposure? Thank you very much for taking my question, this is one of the most difficult things I have ever experienced as a parent

[RapidRod]

I liked the answer Dr. HHH gave you and I'll have to agree with him. You can go forum to forum and you are going to get the same answers.

[scareddad]

I received a fairly low risk needlestick from an insulin needle (unknown patient, therefore unknown HIV status, no visible blood, small gauge needle, subq injection).  I was such a stress case that the Dr. ordered an RNA PCR test at 24 days post needlestick.  The result was <400 (undetected).  I now realize that this test was a big gamble because of the high rate of false positives and in retrospect would not have had it done due to this fact.  But, since it was done and was negative, I am wondering what the value of this negative result is?  I know that I will need to follow-up at the 3 month mark to know for sure, I am just wondering how reassuring this result should be considered at 24 days?  Ann seems very knowledgeable and up to date on current info and I was foping she would post a reply.  Thank you very much.

[Ann]

scared,

I've merged your new thread into your original thread - where you should post all your additional thoughts or questions. It helps us to help you when you keep all your additional thoughts or questions in one thread.

If you need help finding your thread when you come here, click on the "Show own posts" link under your name in the left-hand column of any forum page.

Please also read through the Welcome Thread so you can familiarize yourself with our Forum Posting Guidelines.

Thank you for your cooperation.

You need to get your story straight mate. Either way, whether it was you or your imaginary daughter, you didn't have a risk. Hiv isn't transmitted via needles left lying around.

Ann

[scareddad]

OK, you got me it was my daughter and she is very real.  If you are a parent, you also understand my anxiety.  The needle was found on the floor of an elevator in a hotel and likely hadn't been there more than a few minutes, could you please tell me the value of the negative result at 24 days.  Also do you know if B19 Parvovirus (Fifths disease) affects ELISA testing.  She just got over the Fifths disease rash and now I'm concerned that the antibodies could cause a false positive on the ELISA.  Sorry for the ruse.

[Ann]

scared,

Somehow I get the feeling it really was you - I mean why lie? But that's irrelevant. The only things that MIGHT cause delayed seroconversion is cancer chemotherapy, anti-rejection drugs taken following organ transplant or injecting street drugs daily for years. Assuming your "daughter" doesn't fit any of those circumstances, an antibody test performed at 12-13 weeks is conclusive.

But why put your "daughter" through that when there was no risk? You've already had a negative PCR and they are pretty much good as gold at 28 days. If there were an actual risk, a negative PCR still must be followed up with antibody testing at 12-13 weeks. But you didn't have a risk.

No risk means no test. Not one person has ever become positive from getting stuck with a needle left lying around and you or your "daughter" won't be the first. If you've heard otherwise, you've heard an "urban myth" and heard wrong. There are NO documented cases of this happening - although there have been plenty of opportunity for one to be documented because of people getting stuck with random needles.

Ann

[scareddad]

Here is what we went have been thru.  Needlestick happens, call pediatrician in home town, they say take her to ER.  ER doc says little to no risk because the part of the needle that stuck her was the underside of an insulin pen needle, part that enters pen, although still hollow bore.  Get back home and take her to Pediatrician at their request.  They decide testing is in order just to be safe.  Run baseline tests which were obviously negative.  Run PCR at 24 days because I was a stress case, negative.  What I am trying to learn now is whether this test is worth anything at 24 days.  Every time I look at my little girl, it reinforces my fear because she is truly the most wonderful thing in the world.

[Ann]

scared,

Did you bother to read what I just wrote?

But why put your "daughter" through that when there was no risk? You've already had a negative PCR and they are pretty much good as gold at 28 days. If there were an actual risk, a negative PCR still must be followed up with antibody testing at 12-13 weeks. But you didn't have a risk.

Not only has there not been a risk, but if by some fluke transmission occured, the PCR would not have been negative at 24 days.

There was no risk to begin with - so stop putting yourself through this.

Ann

[scareddad]

Your not exactly gentle but you are making me feel somewhat better.  When does HIV RNA generally show up on a PCR? 

[Ann]

scared,

What do you expect when you come here and change your story around? It makes you come across as a time waster.

I suggest you read the Welcome Thread and follow the Lessons links.

Ann