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Author Topic: Need Help!!!!!  (Read 4228 times)

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Offline MgO

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Need Help!!!!!
« on: June 20, 2006, 04:57:11 AM »
I know a friend who is performing volunteering work in a clinic in San Isabel, Guatemala. Recently, he has just had a 'little' accident when suturing a laceration for a man. He stuck the needle that had gone through the skin of the man into his thumb and caused bleeding. Later he learned that this man was a homosexual. Right on the day of the possible infection, he started a flu with high fever, diarrhoea, sore throat, vomitting and other common symptoms of a flu. Now it's been a few days, but he still has a low-grade fever with weakness, tiredness and headache. The thumb that had been stuck is still very painful and is infected. He and I are extremely worried about the possibility of him being infected with HIV, because there is a high percentage of unprotected sex and HIV infection in Guatemala.

Could any one help me? Is he at a high risk of being infected with HIV?

Offline RapidRod

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Re: Need Help!!!!!
« Reply #1 on: June 20, 2006, 05:11:26 AM »
Symptoms of HIV do not come on that fast. If he cleaned his wound, I don't see any risk for HIV from the suturing incident.

Offline Ann

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Re: Need Help!!!!!
« Reply #2 on: June 20, 2006, 05:13:21 AM »
MgO,

For a start, would you be as worried if this person wasn't gay? You need to know that one does not have to be gay to have hiv and it is insulting to suggest otherwise.

Symptoms or the lack of symptoms mean nothing when it comes to hiv infection. If they happen at all, they happen between two and four weeks after infection has taken place, not the same day.

As this accident happened while suturing, it is unlikely that hiv transmission occurred as the needle used for suturing is not hollow-bore. However, it would be prudent for your friend to be tested for hiv and hepatitis as well. Hepatitis B or C infection is more likely under these circumstances.

The vast majority of people who have actually been infected will seroconvert and test positive by six weeks so a negative test result at this point is an excellent indication that transmission has not occurred. A negative result at six weeks must be confirmed at the 12-13 week point.

If your friend is performing laceration suturing on people, then he must have a qualified medical background and should know these things. Why is it that he doesn't?

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline MgO

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Re: Need Help!!!!!
« Reply #3 on: June 20, 2006, 05:26:27 AM »
Thank you, Ann.

Actually I do not know much about his medical background. All I know is that he is an undergraduate student and is assisting in a christian mission clinic. It is a volunteered work, and there are several other assistants working there under the lead of two doctors. We both have thought that HIV symptoms don't come so fast, but he is still concerned about the possibility for HIV infection.

Offline Ann

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Re: Need Help!!!!!
« Reply #4 on: June 20, 2006, 05:36:45 AM »
MgO,

He should report this incident to the doctor in charge of the clinic and let them take it from there. He should have done this immediately.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline MgO

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Re: Need Help!!!!!
« Reply #5 on: June 20, 2006, 05:40:33 AM »
Ann,

He has done this immediately after the incident. They have taken the blood sample of the patient and sent it to a lab in Guatemala City for testing. We are now concerned about the possibility of a HIV infection. Is it very high?

MgO

Offline Ann

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Re: Need Help!!!!!
« Reply #6 on: June 20, 2006, 10:03:55 AM »
MgO,

As I mentioned in my first post, I don't think the possibility is very high, no. A suture needle is not hollow bore and even with hollow bore needles, not every needle stick results in infection. The number that do is very low for hollow bore needles and I've never read of a case involving transmission via suture needle. I recommend testing only as a precaution and only if the patient's test result comes back positive.

Also as I said previously, hepatitis (B or C) is a more realistic possibility and I certainly hope this is being looked into as well. Any form of hepatitis is much more infectious (than hiv) where blood contact is concerned.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline jkinatl2

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Re: Need Help!!!!!
« Reply #7 on: June 20, 2006, 10:09:09 AM »
Your friend would behoonve himself by taking a course in infectious disease of ALL sorts, including blood-borne pathogens, either thorugh a university internet or at his clinic. Needle sticks are a VERY common occurance. It's going to happen again.

In places like Quatamala, doing voluinteer work, ignorance is NOT bliss. And being a well-meaning and religiously motivated volunteer will make scant difference to the pathogens with thich he comes across. Frankly, whomever let him ship himself off to another country without full knowledge of pathogenic structure and prevention did an irresponsible thing. Let's hope that he does not add hepatitis, malaria, and/or TB to his list of accomplishments in the volunteer arena.



"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline MgO

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Re: Need Help!!!!!
« Reply #8 on: June 21, 2006, 11:30:54 PM »
Ann,

The patient's test result came back positive for HIV. According to my friend, he stuck himself with the needle quite deep. The doctor in charge has suggested him to take PEP treatment at about one week after the incident.

Is the PEP treatment too late for him? How long should it last? What else should he do?

Thanks.

Offline DingoBoi

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Re: Need Help!!!!!
« Reply #9 on: June 21, 2006, 11:52:59 PM »
if pep is to be effective it must be begun within 72 hours.  Preferably asap after possible exposure.   After a week pep will be of no use.  I can't imagine a doctor recommending starting it after a week.

a pep regimen lasts 30 days and is very difficult to complete for many people.  (these are the same drugs most of us positives take every day).  these are some of the most toxic and side effect causing drugs available.

I definitely go with everything ann has said.  Something isn't right in the state of denmark.  Of course, that is why we recommend that the actual person with the concerns post here and not third parties on their behalf.



« Last Edit: June 21, 2006, 11:54:43 PM by DingoBoi »

Offline MgO

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Re: Need Help!!!!!
« Reply #10 on: June 22, 2006, 01:10:41 AM »
I'm sorry that this friend does not have access to the Internet down there. Even PEP is not available at the clinic. He has to go to another town to get the treatment.

The test result of the source patient only came back today, and I guess the doctor did not take this seriously until the patient was tested positive for HIV. Thank you for your concern anyway.

I have a question here to ask: based on the information above, what is the probability of him getting infected without the PEP treatment?
« Last Edit: June 22, 2006, 01:12:49 AM by MgO »

Offline DingoBoi

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Re: Need Help!!!!!
« Reply #11 on: June 22, 2006, 01:30:42 AM »
asking the same question again and again will only get you the same answer which i'll quote what the wise and revered ann has spent precious time already posting:

Quote
As I mentioned in my first post, I don't think the possibility is very high, no. A suture needle is not hollow bore and even with hollow bore needles, not every needle stick results in infection. The number that do is very low for hollow bore needles and I've never read of a case involving transmission via suture needle. I recommend testing only as a precaution and only if the patient's test result comes back positive.

Also as I said previously, hepatitis (B or C) is a more realistic possibility and I certainly hope this is being looked into as well. Any form of hepatitis is much more infectious (than hiv) where blood contact is concerned.

The answers wont change from that.
« Last Edit: June 22, 2006, 01:33:55 AM by DingoBoi »

Offline MgO

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Re: Need Help!!!!!
« Reply #12 on: June 22, 2006, 01:43:21 AM »
I'm sorry for repeating my question. I'm getting extremely worried about all these. The needle stuck into his thumb pretty deep and there was visible blood on the needle. I guess these details would probably increase the possibility somehow.

Thank you for all your help. I really appreciate it.

Offline Ann

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Re: Need Help!!!!!
« Reply #13 on: June 22, 2006, 09:16:26 AM »
MgO,

Dingo is absolutely correct when he says that it is far too late for PEP to be any use.

I still believe the chance of your friend being infected from this incident is remote - although not completely impossible. As it is now too late for PEP, the only thing that can be done is testing at the appropriate time.

As the vast majority of people who have actually been infected will seroconvert and test positive by six weeks, a test at this point will be an excellent indication of your friend's true hiv status. A negative result at six weeks needs to be confirmed at the 12-13 week point.

Tell your friend we here at AIDSmeds.com said we wish him good luck, and also tell him to try to not get too stressed out while he waits to test. The odds are in his favour of testing negative.

Feel free to keep us posted.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

 


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