[Question #10643] HIV risk from blood draw

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21 months ago
I am worrying about a recent incident (due to hiv phobia) and would like to know your expert opinion on this. Yesterday went for a blood draw ,from major lab in Toronto. Blood draw was very clean (they followed standard procedures) and neat so no issues with that.
This is not about the blood draw puncture wound, but about a previous superficial scratch on the same hand where it came to contact with phlebotomy chair.
Unfortunately, last Tuesday (5 days ago) I had a very minor superficial scratch on top of my mid forearm (same hand use for blood draw).  At the day of blood draw, I didn't cover the scratch with a band aid as it was really dry/healed.
At the time of the blood draw I rest my right hand on phlebotomy chair and my healed scratch/scar was touching the phlebotomy chair armrest all the time. I didn't notice any visible blood on phlebotomy chair (I am pretty sure but not 100%). These sites are maintained in a really well manner but I don't think they clean the chairs after each use (but they keep 2-4 mins gap between each use). 
After came home I checked the healed superficial scratch. It was fully closed and  skin was dry, pink and shiny. I pinched and pressed the healed scratch but no fluid or blood came out of it. I wipe it with a tissue with pressure it was dry and nothing came out of it (seemed like its properly sealed off)
1.What is the risk of getting infected with HIV, If there was blood on the phlebotomy chair armrest and it came to contact with my healed superficial cut?
2.Can HIV blood enter in to my body through this area as it a newly healed superficial wound? Can I consider this skin as intact skin?
3.Do i need to test for HIV or go on pep?
4.What if there were HIV+ blood drops on armrest from previous patient and it came to contact with my healing superficial cut?
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H. Hunter Handsfield, MD
21 months ago
Welcome to the forum. Thanks for your confidence in our services.

You describe an implausible scenario. First, there has probably not been a case of HIV acquired during venipuncture (blood drawing) for 40 years, if ever. Maybe rarely back when syringles and needles sometimes were re-used without adequate sterilization. More recently, with near universal single-use devices, undoubtedly it has never hapened. Second, the specifics of the situation you describe are frankly implausible. Third, exposure of a healing scratch on the skin to the virus, or to HIV infected blood, would not risk infections -- and certianly not when the site "was fully closed and skin...dry, pink and shiny". As you predict yourself (sort of), this is nothing more than your HIV phobia. To your specific questions:

1. No risk at all, even in the scenario you describe ("blood on the phebotomy chair" etc).

2. No, certainly not in an amount that would allow HIV exposure, even if in contact with known HIV infected blood -- which itself is extremely unlikely.

3. You definitely should not take PEP on account of this event; with a truthful account of the situation, I doubt you could find a physician or clinic willing to prescribe it. You should not even be tested for HIV.

4. Still no risk.

I suspect you're not surprised by this reply, but I hope it has been helpful. Let me know if anything isn't clear.

HHH, MD

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21 months ago
Appreciate your advice.
Actually this scar was on the outer forearm where I rest it on the phlebotomy chair and my  scratch/scar was touching the phlebotomy chair armrest until blood draw was done ( i didn't not cover it with a band aid as it seems dry and healed) . I had this scratch, 5 days before the blood draw (no blood or liquid coming out of it even when pinch hard). I never had any other sexual contacts or issues with stds.

1. As this is a healing scratch (skin was dry, pink and no scab) can I get infected with hiv if there were unnoticed blood left on the phlebotomy chair from previous patient? 

2.As per your advice I do not need PEP or HIV testing. Can I continue having sex with my spouse? I am really worried about her?

3. I red in this forum that superficial cuts are not a risk of getting HIV even they get contacted with HIV+ blood. What is the reason for that?

4. If there were blood on chair would this this be consider as a exposure in the environment ?

5. Can I move forward with my life by considering this event was a no risk event for acquiring hiv? what is your advice? 

Thanks a lot!
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H. Hunter Handsfield, MD
21 months ago
These are the same questions already asked, or versions of them, using different words. I haven't change my mind!

1. This has never heppened and it's nothing to worry about.
2. Correct and yes; your spouse is not at risk of HIV or anything else from the events described.
3. Most likely it is because for HIV infection to take hold requres that LARGE AMOUNTS of virus must have contact with MANY SUSCEPTIBLE CELLS DEEP INSIDE. But the biological reasons don't matter: if such exposures never result in infection, who cares about the reasons?
4. It would be an exposure, but with no risk of infeciton.
5. That's the whole point of all my comments:  You should not be remotely concerned about the no-risk events described and should move on without giving any of this another thought.
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