searching for clarification

[carrie]

Hi,

I have searched through your archives but unfortunately have not been able to find the answers that I am looking for.  I apologise if this questions falls out of the remit of an 'am i infected' forum but I just don't where else I might get this info from and answers to these questions would provide an ability for me to be able to move on from an incident that happened many years ago.

I live in the Middle East and for many years there were unethical practices in doctors and dentists and even now the ministry of health isn't the best regulator of universal precautions.

A dentist that I used to visit regularly was investigated for re-using equipment, including injecting equipment.  He was investigated but skipped the country and as is typical of my country the ministry would give no information about it.  I tested for many things, including HIV, and was negative.

This experience has however left me with some anxiety regarding health care professionals.  I know universal precautions exist but believe me here they are not always adhered to and although I always advocate for myself and ask about their universal precautions it still leaves me with unease.

Upon researching this and educating myself better on transmission I fail to see how HIV can be transmitted via a used syringe or needle in a dentist office and I am interested to know if I am right, an answer to this will really make a huge difference in my life.

to my knowledge HIV could NOTbe transmitted for the following reasons:

1. Any blood left from a previous patient on the needle would have been exposed to the air and therefore deactivated.

2. Any blood in the barrel of the syringe protected from exposure to the environment would be in contact with the local anesthesia AND according to a few sites I have seen local anesthesia would deactivate HIV - is this true or a myth??

3.  10-15 minutes (tine between patients) would be enough to deactivate blood in the syringe and unless the dentist was immediately injecting patient after patient an infection is improbable as although not exposed to air the virus in the barrel of the syringe would have degraded enough to render it unable to infect.

I am trying to look at this from a scientific perspective not an anxious one and just want to know if my understanding of HIV science is correct and this is why an infection at the dentist IF universal precautions were not followed couldn't happen anyway.

I thank you in advance for your help and I hope that you will address from the perspective of a country that is not as advanced in its adherence to universal precautions as western countries.

Regards

C

[jkinatl2]

Hello!

Please bear with me, this post might evolve over several days. I just wanted to let you know that I am taking it seriously and that I am doing some research. Don't reply, as you only have three free posts.

Your questions and concerns are completely valid. OSHA and parallel standards in developed countries are so universally applied, monitored and taken for granted that it's the very rare deviation from them that makes headline news. In many places in the world, the opposite seems to be the case. And as I often tout that this is a global web resource, it is vital that we understand the issues impacting places where OSHA and the like are not the norm.

Here is a quick bullet point, that I or one of the other moderators will likely expand upon later.

1. Blood on a non hollow-bore needle will be inert insofar as HIV is concerned within an instant. That is no HIV risk (it is obviously a hepatitis risk) whatsoever.

2. I am trying to parse your scenario here. Someone is given anesthesia, but then blood is somehow drawn into a needle during the procedure? So we are not talking IV anesthesia? If I am following you, then there would be a risk for HIV by re-using a needle to deliver a drug.

3. HIV's viability inside of a hollow bore needle depend on a wide variety of variables. How much HIV (how high a viral load), the environment in which the needle is located/stored, the presence of antagonistic particles (chemicals or substances that are antagonistic to HIV's glycoproteins) and temperature. Theoretically, in a lab setting, such needles have contained viable HIV particles for six weeks. However, statistical data indicates that only a few minutes in a non-lab setting are enough to render HIV inert.

Ten? Fifteen? While I would be alarmed if transmission actually occurred, I would not be alarmed if viable HIV was isolated from a syringe with such a resting time.

My understanding of the virus leads me to believe that, though infection COULD happen in a dentist's office that disregarded universal procedures, it would nonetheless be unlikely in the extreme. I would be FAR more worried about Hepatitis and other pathogens.

I hope this has made some sense, and has helped alleviate some fear.

I might write more as I research further.

[carrie]

Thanks so much for  your response it is so nice to know that you understand that unfortunately not everywhere in the world has first class medical services that follow strict protocol.  It is a shame but here we do not have the monitoring that you do.

That said, I have managed to find a fantastic dentist who has suggested that I go and see him and he will show me how the clinic operates and how they sterilise everything.  It may seem to others as paranoid or over the top but having been in a situation of doubt and worry I must be an advocate for my own health.

If you do find out anymore information that would be fantastic and I also thank you for your reply to my post that demonstrated great understanding of issues that some of us face.

Thanks and kindest regards

C