Question:

I work in a dental office and yesterday I was removing used instruments to bring in to be sterilized. I felt something sharp at the time like I had touched one of the instruments. When I got back into the operatory, I washed my hands with Dial soap and inspected both hands, front and back of each, and didn't see any marks. This morning, I noticed a scratch on one of my fingers and I cannot remember how or when I got it. I'm freaking out because I am worried that I was hit by an instrument. There was blood on it and the thing that scares me to death is the patient is HIV+. There was no bleeding on my finger after the incident took place. I called the CDC and they told me that HIV cannot live outside the body. What do I do? Go to the ER and see about antiretroviral meds? Help me please.

Answer provided by:

Mark H. Katz, M.D.
Department of Internal Medicine
Assistant Chief, Hospitalist Division; Kaiser Permanente of West Los Angeles

Using antiretroviral meds as post-exposure prophylaxis is generally recommended only when there is an encounter in which the source patient is known to be HIV-positive. I doubt that any specialist would recommend these for your situation, given the low likelihood of this being the case.

Additionally, you speak of an exposure which is not verified, only possible. I think it is fine for you to move on without further investigation. However, since this occurred at work, there are reasons to report this to your supervisor. An HIV antibody test might be recommended, at baseline (now) and again at 3 months, but indeed, this would be up to you and your provider/supervisor.

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