POZ Community Forums
Main Forums => I Just Tested Poz => Topic started by: jah_rn on June 27, 2012, 11:54:43 pm
-
First of all I find it shocking to be here, but I am taking it in strides. I had a needle stick on February 29, 2012 from a TB syringe found at the scene of an apparent OD. It was unknown if the needle was from the person who OD'd or someone else. Regardless, I got stuck. The needle had dried blood on barrel and needle of syringe and had a pink tinged fluid inside the barrel (overt blood). Reported to employee health ASAP but was delayed by 4 hours as my workflow was too chaotic at the hospital in the ED. The presumed source tested neg for HIV but positive for HCV, so I was only surveilled for HCV. The prophylaxis therapy for HIV was withheld due to MD thinking risk was nothing for HIV. I was neg for HIV HCV and HBV at time of injury. I remained negative for HCV for 3 mos. I was tested at clinic in March 2012 for HIV and neg. I developed a high fever, anergy and anorexia (lost 20lbs I could not afford to lose 165 to 145) on May 29, 2012 and day later had adenopathy and 2 days later a rash started and spread from face to limbs and trunk, by Sunday I couldn't take it and went to the ED where I work, as my PCP wouldn't see me in the office or take a sick call from a partner MD. I was worked up for fever of unknown origin. I was smart enough to know HIV was in my differential...I looked like people I had taken care of decades ago. I requested HIV testing and the rapid and ELISA came back neg, but my WBCs were decimated, and I was neutropenic. I started high dose broad spectrum antibiotics. ID was consulted, and more sensitive testing was done including a PCR qualitative for HIV. Luckily, my fever broke from 104.7, and I was discharged 3 days later with PCR pending. I called two days after discharge and was told over the phone that HIV was detected and I would need a VL to confirm and repeat ELISA with reflex WB. Tested positive on June 3rd by PCR. Still have no ABs but VL is over threshold for testing. My occupational health won't accept my claim and "presume[d] [its] from my lifestyle" to quote him. So for the first time in over a couple decades, I was made to feel dirty or ashamed to be gay. Not taking it lying down, but it was hard to swallow from a fellow healthcare provider. I have told my coworkers who are supportive, but it's hard taking care of others while I'm sick. Meanwhile, June 25, 2012 I had my initial intake with my outpatient ID and will start treatment ASAP. I am waiting on serology for genotype and baseline labs. I still have adenopathy and chronic pain at the sites of these swellings, not to mention my calves throb and ache all the time. I know some information, and I have been reading research and publications from legitimate sources, but any suggestions on coping with this mentally and not allowing myself to spiral would be helpful. Also, I have no energy since that awful day in May any suggestions...I miss my runs and gym time!
-
only waiting would help. don't get too depressed. i was quite active. working out on gym and studying. i was planning to have the brightest future but now i have hiv. it has been 3 months now and i still have less energy. i think i only get my previous energy after i start meds. but it is going better everyday believe me.
-
I am sorry that you got HIV and welcome to this forum.
It will take time to chill out about everything. Well it seems you'll be a fighter and seems you want to treat asap so this will speed up things.
On the other hand, it does not make sense to me, either, the timing of your claim you had a needle stick on that date, and acute seroconversion 12 weeks later. This seems to be outlier timing but I guess anything is possible. This is probably the reasoning behind the comments from "occupational health". (When exactly did you lose the weight - before you finally got the fever, rash, etc? Cause that late May sickness seems like the seroconversion moment. So how to explain the weight loss and no seroconversion earlier? Maybe as you go forward you can get clarification on this from your ID.)
I am not sure that comment was meant to shame you, rather it was kind of clumsy and unthinking. It was a euphemism for saying the person thinks you got HIV from a more recent risk from sex, and not from the needle stick. Thats not the same as saying all gay people have HIV or all HIV people are gay, or HIV is dirty and shameful, or that gay sex is dirty and shameful. Just saying. The person just thinks the timing doesn't add up. But yeah, he/she should have said "seems like a different risk" or "seems like perhaps a sexual risk" and not said "lifestyle" meaning gay sex. Cause it could be hetero sex just as well as gay.
What are your options for pursuing your claim, now, that it was the needle stick? If you really need that decision reversed, I guess you need to explore how that could happen.
-
I'm assuming I'll have ABs soon, so the fever and adenopathy I experienced in late May is the seroconversion which puts me at about 3 months from exposure.
-
mecch,
The weight loss started in May with the fever and continued into early June. As far as gay sex, I explained to Occ Health MD I have not been sexually active with anyone other than myself for about 2 years...pathetic I know, but career and continued education limit free time. Especially working five days a week at 12 hours a day. After being told all this at the baseline testing, the comment was still made. As far as the timing and outlying infections, HIV infections have been reported to be acquired up to 12 months by legitimate researchers and some suspect research is 18 months, and my acute initial infection falls well within the expected timing acoording to our own CDC guidelines:
Ninety-seven percent of persons will develop antibodies in the first 3 months following the time of their infection. In very rare cases, it can take up to 6 months to develop antibodies to HIV (http://www.cdc.gov/hiv/topics/testing/resources/qa/index.htm , April, 9, 2010).
I'm sure about my exposure and risks, and I'm very certain it was from my job and more specifically this needlestick.
As far as my claim, I am not going to discuss specifics but internal and external resources/avenues are being pursued. I am also encouraging my workplace to enact better procedures to prevent this from reoccurring and to catch things like this earlier by pushing for HIV PCR testing, in addition to AB and rapid testing, at baseline and surveillance to catch infection earlier.
-
Well a terrible event thats for sure. (6 - 12 months, i didn't know that.. thanks.).
Good for you for pursuing your own rights and better followup for all your colleagues.
I had a violent seroconversion and lost a lot of weight. Also went on HAART quite quickly and all was soon enough repaired. Wishing you the best for your own "reconstitution".
-
Hi jah_rn,
Do not be surprised if people are dismissive of your claims; the truth is that your story is really bizarre. If your story is true, you are an outlier on many, many fronts.
I would highly doubt the validity of your PCRs at this point. PCRs have a far greater tendency to generate false positives. What was your VL? If it was below 1000, then it has all the makings of a false positive. Since both ELISA and WB are negative, you should NOT consider yourself positive as yet.
AC
-
Sorry to hear your story.
"Tested positive on June 3rd by PCR". PCR DNA qualitative has a high false positive rate, look examples:
http://www.thebody.com/h/pcr-dna-rate-false-positive.html
So suppose that you already did PCR RNA VL after June 3rd by far, does it detect any number of VL?
"June 25, 2012 I had my initial intake with my outpatient ID and will start treatment ASAP." You decide to start treatment without knowing Viral Loading, CD4 counts etc.?
You may still have hope to be negative!
-
You decide to start treatment without knowing Viral Loading, CD4 counts etc.?
You may still have hope to be negative!
I really don't think skimming my post allowed you to glean information. My VL is greater than the tests threshold. My CD4 was pending and serotype is pending. I will start treatment after this is back.
-
"If your story is true.."
I thought these forums were non-judgmental and supportive? Thanks for doubting me!
If you took the time to read my pos,t the VL is greater than the threshold (ie, >500000 iu/ml). As far as WB it is reflexive for a positive ELISA. Since I have no ABs for HIV, my ELISA is neg and a WB was never done. I'm sure it's a matter of time before I mount ABs, as it appears I'm in the initial acute infection.
-
jah_rn,
From your original post, I presumed you were talking about the lower threshold of PCR, which is quite low for both qualitative and quantitative PCR tests. If your VL is in excess of the upper limit of the test, then it is highly suggestive of acute HIV infection.
Once viremia (detectable virus in plasma) happens, which generally coincides with the onset of symptoms, it takes anywhere from couple of days to couple of weeks for antibodies to reach detectable levels.
AC
-
Hi Jah, welcome to the forums.
Your initial post is a bit difficult to read as it is a wall of text with no paragraph breaks. I had to keep re-reading it to understand what you were saying and get all the details.
When writing on the internet, it's best to break what you're writing up into small paragraphs of just a few sentences. Makes it MUCH easier to read.
You should get tested again for hep C. In fact, you might want to test for hep C out to six months if you get another negative hcv antibody result in the next week or so. Sometimes acquiring hep C and hiv at the same time can delay antibody creation to both. It's not particularly common, but it does happen.
I'm glad to see that you are pursuing your case with Occupational Health. You should be given some sort of compensation for being infected through your line of work. If you do happen to end up with hep C as well, this will strengthen your claim. (I hope you don't end up with hep C as well, but coinfection would explain a lot in your case.)
If I were you, I'd also be very tempted to report the person who tried to blame your infection on being gay. That's so not right.
It's incredibly unfortunate that you ended up with hiv from this incident. Infections caused by needle-stick injuries are rare. It sucks. It's a real shame that you weren't put on PEP, given that you could not be sure whose syringe it was or how long it had been since it was last used.
You know, I have to wonder if the syringe did in fact belong to the OD patient - and he tested hiv negative on a rapid test because he's newly infected himself. This would also mean that he likely would have had a very high viral load, thereby increasing the risk to yourself. What a crappy situation.
Hang in there!
Ann
-
Sorry I also had not understood that your VL is high.
-
ann i can understand who wrote the forum was hard to read and comprehend
-
i can care less if 1 is gay or not the case as he was mentioning is suppprt that gotten hiv noone deserves it gay or str8 etc