[Question #9124] HIV From a blood draw

36 months ago

had An exposure 2 months ago and it was unprotected Vaginal sex.tested at 35 days and 56 days with 4th generation test and came Negative. didn’t Had any symptoms during this time.

Im concerned that I was exposed to HIV blood from my second blood test.

the moment I sat on the chair to get the blood test the nurse was acting really weird and strange and went and got the needle from a room near the lab. then needle and syringe was inside a package which was unwrapped which made feel a little bit anxious I tried asking her why the package was already open she didn't understand me because she doesn't speak English so I told her ok and she did the blood draw.

after getting back home and started to have these thought that maybe the needle was reused or she had mixed the needle with Hiv blood before she draw blood from my vein! I got really scared and now I'm really paranoid after 6 days of the blood draw I had scratchy throat & in my 7th day my throat got worsen & also I'm having dry mouth even how much water I drink water it remains dry as well general muscle ache in my back and my arms and slightly my legs and I notice new rash appeared on my back as well on my shoulders. didn't experience fever my highest temp was 37c.

my question are:

1- are these symptoms related to ARS and can they appear after 6/7 days without fever ?

2- does sore throat and slight muscle ache be the first symptom of ars?

3- if the nurse reused a needle which had blood inside of it can this transmit HIV even if the blood was outside the body ?

4- if there was blood inside the needle even if it was one drop of blood can this one drop become mixed with my blood and give a positive hiv results ?

5- what is most likely the cause of symptoms ? note that this week I didn't meet anyone but I heavily smoked more than usual.

6- if I Do a rapid hiv test 3rd generation (abbott hiv 1/2 3.0) after 10 days of the blood draw does it prove that my symptoms are not related to ars ? Or it will be meaningless

Edward W. Hook M.D.

36 months ago

Welcome t the Forum. Thanks for your question. I'll be happy to comment and hope that my comments will help to reassure you. I am not aware of anyone who has acquired HIV from having blood drawn in a health care facility. Blood draws are different from needle sticks- remember that with blood draws the blood is REMOVED from your vein, not INJECTED into it. Thus, even with a used needle, transmission of infection would be unusual. In answer to your specific questions:

1. 6-7 days is on the early side for the ARS and fever is an essential part of the ARS. I suspect your flu-like symptoms are coincidental. When at risk persons with flu-like symptoms have been tested for the ARS, 99% of these persons have something other than HIV such as non-STI viral infections.

2. See my comments above. The symptoms of the ARS typically all start at about the same time, not in sequence.

3. Again, see my comments above- unlikely

4. No

5.See above

6. 3rd generation tests test only for antibodies and might not be positive. I you have a 4th generation, combination HIV antigen/antibody test any time more than a day or two after the onset of your symptoms, it your symptoms were due to HIV, the test would be positive.

I hope you find my responses reassuring. Please don't worry. EWH

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36 months ago

Thank you doctor for the quick response and BTW after my Initial exposure the (unprotected vaginal sex) I read more than 1000+ question on this thread and every response from you Dr Hook and from Dr. Hunter reassured me and let me feel better. so I really I appreciate your help.

the thing that scares me doctor from the day of my initial exposure till the day I did the second blood draw I didn't experience any symptoms because I was mentoring my symptoms really carefully the last two month and its been a long time since I have a sore throat and muscle ache. I want to mention that my sore throat isn't sever I can talk normally and eat normally but I feel like a lump in my throat which it hurts a little bit when I swallow and for the muscle aches it isn't sever as well but its really annoying and discomfort.

I have some follow up questions and I will leave my last follow up for later:

1- without a fever can be assure those symptoms are not related to ars ? or fever may develop late in some cases ?

2- when ars occur they cause sever pain the same Time? or does the pain gradually get worse and more painful after day by day?

3- did you ever heard of an ars case without a fever ?

4- the only test I can do for now is a 3rd generation after how many days I can do the test to prove those symptoms aren't related to ARS?

5- this question is my most important question and Dr if you can explain it in a medical way if its possible or not.

now Im sure that the needle wasn't reused because the tip of the needle and the needle hub wasn't visible blood on them. but i think the only way is that she has mixed the needle from a test tube then wiped the blood from the needle.

I know this unusual thing that she did that but if it happened in a biological standpoint if blood in the test tube had high viral load and needle was mixed with this blood and wiped off and after 3-5 min I used this needle to draw my blood with it. can it lead to infection ? please doctor don't consider as an anxiety question I just want to know if that leads to infection and also if the blood in the test tube remains infectious ??

Edward W. Hook M.D.

36 months ago

Straight to your follow up questions. My sense is that you are worrying far more than you really need to be:

1. Fever is an essential part of the ARS. No fever, this is not ARS.

2. The onset of ARS symptoms tend to occur at about the same time, they may get worse with the passage of time however, from your description I have little or no concern that they are the ARS.

3. No

4. There are not good data to help answer this question however, a negative 3rd generation test a week after symptoms begin would be very strong evidence that the symptoms were not due to HIV

5. The situation you describe is not "unusual", it is unheard of. You need to put these unwarranted concerns aside and more forward. EWH

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35 months ago

hello again doctor I would like to update additional information regarding my exposure. I have 5 questions I would really appreciate if you give me detail answer for every question it will help me to reassure myself.

1. I did a 4th generation test at 9 days post the blood draw and it was Negative. I did the test 2 days after my sore throat and slight muscle ache developed. Can I be 100% sure that those symptoms was not ARS and can you please explain why ? and was 2 days enough for antibodies to show on the test ?

2. My sore throat at day 8 and day 9 started to gradually decrease and at day 10 it was clear out but at day 11 i feel its came back when I swallow but without any pain and for the muscle ache which started at day 7 and at day 9 it disappeared completely. regarding this information do you think its more evidence it was not ARS ? Because it wasn't sever and cleared out after 2 days but for my throat it comes and goes.

3. I want to ask you regarding a new symptom I developed which is Sweaty palms hand and feet (no night sweats) and with sweaty palms I notice some white pimples on my finger which I knew its called dyshidrotic eczema and also some finger skin peeling.

does sweaty palms ---> dyshidrotic eczema ---> skin peeling. ---> characteristics related to ARS in any way ?

4. this is my 12th day after exposure and still have normal temperature (no fever) so I was thinking if fever is essential part of the ARS and if I monitor my temperature for 21 days and if I didn't get fever does this give me at least 40-50% that I don't have hiv? and of course I know I should get tested.

5. My Final question as I mention Im scared from the blood draw exposure if the needle was reused or had blood in it. so if the needle had blood in it would it appear on the test I did after 9 days ? because if the blood got inside my blood stream wouldn't it show on the test faster than for example sexual exposure? I really would to know the answer for this question.

Thanks doctor.

Edward W. Hook M.D.

35 months ago

As you know, we provide up to three responses to each client's questions. This 3rd response will complete this thread which will subsequently be closed without further responses.

1. Symptoms are due to the reaction of the virus with the host immune system (antibodies). When symptoms are present, 4th generation tests are always positive any time more than a day or two after the onset of symptoms.

2. This was not ARS- see my earlier comments

3. Sweaty palms are not a symptom of HIV. They may be a sign of anxiety. The same is true for peeling skin and dyshidrotic eczema

4. Yes although as you point out, many persons who acquire HIV do not experience the ARS.

5. Largely repetitive. The time to a positive test is highly variable irrespective of the mechanism of infection. More than 98% of tests are positive at 4 weeks and results are entirely conclusive at 6 weeks. I remain confident that you did not acquire HIV from the exposure you describe.

This completes this thread. Please don't worry. Take care. EWH

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