[Question #2931] HIV RISK from the incident

41 months ago
Hello Doctor, I'm a 25 years old healthy female. I visited my dermatologist today for a laser procedure which was for the cherry angioma on my wrist.
She used Pixel laser technology for this. Every time I'm about to encounter anything invasive, I always ask if everything used was sterile upto the mark. And I did the same today. The assistant informed me the the laser has re-usable tips and not disposable ones. They use some anti-septic solution to clean it and re-use it on the next patient. I'm fearing, if this wasn't done correctly, would it transmit HIV/HCV from laser? Since the tip does prick the skin and it did cause some amount of bleeding. 600 joules was the current used ( dont know if this was relevant ). Do I need to get tested??  Please help
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Welcome to our Forum.  I would classify the risk of your having been infected with HIV or hepatitis C from your recent laser treatment as zero and see no need for testing.  The reasons I have assessed your risk as zero are:

1. The laser beam would destroy and bacteria or viruses present on either the device or the skin
2. Your bleeding (rare after laser therapy) occurred as the result of damage to your skin and the angioma, not due to penetration by the laser device.
3.  There are no reports of either HIV of hepatitis transmission ever occurring following laser treatments
4.  It is statistically unlikely that the last tip was used on a person with infectious HIV or hepatitis C before you and that the tip was therefore contaminated.

Because of all of these reasons, I would see your laser treatment as a no risk event in terms of HIV/HCV risk.  I see no need related to your laser treatment for testing.  I hope this comment is helpful to you.  EWH
---
41 months ago
Hello Dr. Thank you for your detailed explanation which was very helpful to relieve my fear of catching the infections. I was unaware of the fact that there is no skin penetration with laser. i feel so relieved now. 

Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Great, glad my comments were helpful.  EWH---
41 months ago
I'd like to inform you that I had radiofrequency ablation done 15 days before for the same angioma. Does the risk differ from laser? Is it possible to transmit hiv/hcv through this technique, if the electrodes are contaminated? also, does the statistics vary for India? ( referring to your previous response, as I'm located in India. ) a negative should be held confirmatory at what day? 
Thank you.
41 months ago
And also, my wound with laser is around 20 hours old now. I was told to leave it uncovered , there's no active bleeding from it, but i touched the pot-seat by mistake in a public bathroom (unisex), I'm scared if there were any semen/vaginal secretions on the seat. as it was wet and i went to clean it with a tissue and was trying to wipe that off, and might have touched my laser wound with the toilet-seat surface by mistake. Is transmission possible in this way  or the way i mentioned previously with radiofrequency ablation?? should i get tested?
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Radiofrequency ablation is similar to laser in that is uses radio waves (rather than light as the laser does) to create heat.  I would assume that the risk (noe) is the same for this procedure as it is for laser as once again, the device does not directly pierce the skin.

That you are in India does not change my assessment.

I would not worry about the possibility that you may have gotten your wound contaminated in the public bathroom. Still no risk and no need for testing.  EWH
---
40 months ago
Thank you so much Doc. 
Sorry for the late follow up.  I was in a place with no access to internet, so couldn't check our response until now.
I had one last query. My blood titres as a part of college admissions for Hep B, MMR and VZV was done. I remember getting chickenpox and being vaccinated for MMR in childhood.  But my parents are not sure if I was vaccinated for Hep.B. They vividly remember me taking Hep.B in childhood but very unsure of it.  anti-HbsAg was positive and HbsAg was negative, no other anti-body was tested. After reading about it, I understand that this can be seen in vaccination  or past-exposure, no active infection is present.  My question is, does this have any long term consequences if it was due to prior exposure and not vaccination? is there a chance of liver cancer inspite of resolution if this is due to prior infection? Do i need to do anything about it?? 
Looking forward to your expert opinion
Thank you very much

Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
Whether your HBs antibody was due to vaccination (most likely) or infection which resolved on its own, the result shows that you are protected from future hepatitis infection and need not worry about this.  In terms of hepatitis B, you are protected.

As you probably know, we provide up to three responses to client questions. This is my third response.  Thus this thread will be closed later today.  Take care.  EWH
---
40 months ago
Alright. But any risk for HCC? as i mentioned in the previous question??
sorry about the additional question
Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
No, no risk for HCC related to hepatitis B infection either.  EWH
---
40 months ago
Thanks doc.