[Question #1058] knife

87 months ago
I read in aidsmap.com about hiv transmission from knife fight. I request you to kindly go through article and.tell.me authenticity of the http://aidsmap.com/news/HIV-transmitted-during-a-knife-attack/page/1523935

Investigators in Taiwan have identified a case of HIV transmission due to a knife fight. The case is reported in the online edition of AIDS Research and Human Retroviruses. The researchers used phylogenetic analysis to link the virus in the attacker and victim, and they also argue that new HIV testing technology allowed them to determine the direction of HIV transmission.

Most cases of HIV infection have occurred as a consequence of unprotected anal or vaginal sex. However, the virus can also be spread through blood-to-blood, and there are reports of HIV being transmitted during fist fights.

Now investigators have found compelling evidence of HIV transmission from one individual to another during a knife attack.

The attack occurred in September 2008. The attacker was a 42 year old who had been diagnosed HIV-positive in December 2005. His CD4 cell count was 445 cells/mm3 and his viral load was 57,700 copies/ml. He was not taking antiretroviral therapy and had a history of injecting drug use.

He attempted to rob a 69-year-old man and in the ensuing fight both sustained serious injuries and were hospitalised. The victim received blood transfusions during surgery after the fight. He was married with children, and reported no history of injecting drug use or any other HIV risk behaviour. In October 2008 both he and his wife tested HIV-negative.

However, in February 2009 the victim, but not his wife, became HIV-positive.

His blood transfusion was ruled out as the mode of transmission as all the donors were HIV-negative.

Therefore, investigators hypothesised that the individual’s infection was due to blood-to-blood contact during the knife attack.

To test this theory blood samples were obtained from both the attacker and the victim. Both individuals were infected with the same HIV subtype (HIV-1CRF07_BC).

Phylogenetic analysis of both the env and pol regions also showed that the virus in the two individuals was very closely related.

The investigators also believe that they have proof of the direction of HIV transmission. Levels of HIV-IgG were measured in the two individuals. Levels of IgG increase with the duration of HIV infection.

Levels of IgG increased in the victim and, write the investigators, “provided…the evidence for the direction of HIV-1 transmission from the robber to the victim.”

They add, “we conclude that this HIV transmission most likely resulted from blood-to-blood contact during a fierce fight…it is the first case providing HIV-1 seroconversion data as evidence to establish the direction of HIV-1 transmission.”
H. Hunter Handsfield, MD
87 months ago
Welcome back to the forum, but I'm sorry to see that you're apparently still concerned about HIV from blood exposures.

The case report you quote seems valid. What questions do you have about it? I would point out that this case is evidence of HIV transmisison by substantial "blood-to-blood contact during a fierce fight". A single case report like this only means one main thing:  it emphasizes how rarely such transmissions occur. (If it were common, there would be lots of cases and no need for reporting it in the medical literature.) In any case, this event is completely unlike the minor possible (but unlikely) blood exposure you describe in your other recent thread, so it doesn't alter my advice in that discussion. Try to accept the reasoned, science-based advice you have had and stop searching the internet about it. It won't get you anywhere except into a state of even more unjustified worry.

87 months ago
Sir, what is my questions is that ,
1)is it possible to get hiv from knife fight ??I request you to please read above post and tell me authenticity of that post??

2) I used think that , people who do stunt action in film or people who do martial art fighting or people who play games like football have a lot of bleedings wounds which causes large amount of blood to come out of body, yet I don't hear hiv transmission from like this event. Did any hiv transmission happened from like this event ??
H. Hunter Handsfield, MD
87 months ago
1) Yes. That's the point of the case report you posted. I already said the report looks valid (i.e. it seems authentic).

2) I am unaware of any reports of HIV transmission through sports injuries, or among cinema stunt performers. As I said above, the report you found confirms how rare such transmissions probably are.

Please re-read my repy above, carefully; concentrate on every word! If English is not your first language or otherwise you don't understand it clearly, discuss it with a friend who knows English well.

87 months ago
Kk sir, I want tell you what I understood

1) knife fighting or like these events rarely results in hiv transmission.
2) even if mucous membranes and cuts are exposed large amount of hiv infected blood. Hiv transmission rarely occurs.

3) there is no data available on how much blood is required for hiv transmission. I mean small or large.

Am.I right??..

Thank you sir
H. Hunter Handsfield, MD
87 months ago
Correct on all three.

That completes this thread, which will now be closed.

Please note that repetative questions on the same topic are not permitted on the forum. Please do not post any more questions about transmission of HIV risks through blood exposure. Thank you!