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• W2022671617 abstract "To The Editors: The Q & A section of the March 1995 issue contains a discussion of management of a child injured with a hypodermic needle found in a public place.1 Certain aspects of this discussion that pertain to HIV infection require clarification. The risk of HIV transmission to a health-care worker after a needlestick exposure to HIV-infected blood was incorrectly stated; the average risk is approximately 0.3%.2 If the blood on the outside and inside surfaces of the needle has dried, the risk of HIV transmission is probably lower than 0.3%, since the concentration of HIV diminishes by 90 to 99% within several hours after drying and continues to decrease gradually thereafter3, 4. Nevertheless, occasional cases of HIV infection in health-care workers have resulted from injury with needles or other sharp objects that were improperly disposed of, e.g., that were protruding through a non-puncture-resistant waste container (Metler R, CDC, unpublished data). Although HIV infection due to injury with a hypodermic needle found in a public place is very unlikely, the possibility, unfortunately, cannot be dismissed. Many local or state health departments can provide useful information to practitioners evaluating a child after a hypodermic needle injury. The location where the needle was found may be helpful in assessing the likelihood that it had been used by a person at high risk for HIV infection, such as an injection drug user. Knowledge of the prevalence of HIV infection among injection drug users in the community may be helpful in assessing the likelihood of HIV exposure. An estimate of the time elapsed since use of the needle may help to assess the potential viability of HIV. As the discussants point out, laboratory procedures attempting to test the needle for contamination with HIV are not recommended; these procedures are technically difficult, not widely available, and difficult to interpret because of lack of standardization on specimens such as a discarded needle. Recommendations for management of occupational exposures to HIV include testing of the exposed worker for HIV antibody at the time of exposure (baseline) and periodically for a minimum of 6 months thereafter.5, 6 Recommendations regarding post-exposure prophylaxis are currently being re-evaluated.7 For a child injured with a hypodermic needle, the discussants recommend performing only one HIV test, at 6 months after injury. However, a baseline serum specimen should always be obtained and stored. In the unlikely event that a specimen drawn 6 months later tests positive, a negative specimen at baseline provides evidence that the infection was related to the injury. Such evidence may be important not only for legal reasons, but also in helping to resolve questions regarding other possible modes of transmission, including sexual abuse of the child, that will inevitably be raised during the ensuing investigation. David M. Bell, M.D. Centers for Disease Control and Prevention Atlanta, GA" @default.
• W2022671617 created "2016-06-24" @default.
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• W2022671617 date "1996-03-01" @default.
• W2022671617 modified "2023-09-25" @default.
• W2022671617 title "HUMAN IMMUNODEFICIENCY VIRUS INFECTION AND NEEDLE STICK INJURIES" @default.
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