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Blood splash injury on face, mild conjunctivitis. Transmit HIV?

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ENT Specialist
Practicing since : 1991
Answered : 2551 Questions
I am a medical student and approximately 5 weeks I was observing in theatre and I am scared that I may have sustained a splash injury of blood to my face. However I could not see any blood on my face afterwards, if there was anything it would have been very minimal. I subsequently went to occupational health who told me I was not at any risk of blood bourne viruses as it was a very low risk incident and I should not worry. The patient was also not known to be HIV positive.

Despite this, since then, I have been very anxious. For the last 2 weeks I have been suffering from mild conjunctivitis. I am very scared that this is linked to the possible HIV exposure and that I am capable of passing on HIV to others via contamination with my conjunctivitis. No one else has yet caught my conjunctivitis infection from me, however if they did - would they be at risk from HIV if I did have it? Can HIV infected person infect other with HIV via conjunctivitis?

I have tried to be very hygienic by washing my hands all the time and not touching my eyes but I'm still worried I could pass HIV on to my close contacts and patients that I see. My conjunctivitis tends to only be purulent in the mornings and looks relatively normal in the day.

I look forward to your response as I am extremely anxious regarding this issue.

Aimee Collett
Mon, 21 May 2012 in HIV and AIDS
Answered by Dr. Sumit Bhatti 37 minutes later

Thanks for the query.

1. Trans-conjunctival spread of HIV virus is very rare with a risk of less than 0.001%.
2. This risk is the same as for spread after contamination of HIV infected blood on damaged or broken skin
3. The chance of infection is much lower than Hepatitis B or C which is 1-40%. The risk of infection depends upon:
a) The amount of blood splash which in your case was minimal, if any.
b) The amount of HIV virus present in the patient's blood, and in your case, the patient was HIV negative.
4. You do not require any post-exposure prophylaxis for this incident.
5. Your conjunctivitis may be have developed after repeated washing of eyes. Treat it like any routine conjunctivitis. Visit an Ophthalmologist. You can transmit conjunctivitis to other close contacts, if it is infective in nature.
6. It is good that you are washing your hands regularly. Always wear a eye protection.

Hope I have answered your query. If you have any follow up queries, I am available to answer them.

Above answer was peer-reviewed by
Follow-up: Blood splash injury on face, mild conjunctivitis. Transmit HIV? 1 hour later
Thank you very much for your response, however the thing that I was actually worried about was whether if I did happen to have HIV (despite the unlikeliness of the exposure) could I pass the HIV to close contacts via my own conjunctivitis? As I have read that the HIV virus can cause conjunctivitis itself.

Would my close contacts only be at risk of catching conjunctivitis and not HIV? I'm just worried about the others around me.
Answered by Dr. Sumit Bhatti 4 hours later
1. If you consider yourself at risk, get your baseline HIV testing done. You will have to repeat this at three to six months, sometimes a year (to account for delayed sero-conversion).
2. The risk of transmitting HIV conjunctivitis even with close contact with tears and droplets will be more than one in million.
3. In HIV, other viruses and organisms are usually involved due to lowered immunity. These may be transmitted without transmitting HIV. Therefore you must follow the usual measures to protect your near and dear, especially if it is infective in nature.
4. Get your eye check up done. HIV conjunctivitis, even if present, will heal with no specific treatment. If your conjunctivitis persists for an unusually long period, then further testing will be mandatory. Has anyone in contact with you developed similar conjunctivitis?

Above answer was peer-reviewed by
Follow-up: Blood splash injury on face, mild conjunctivitis. Transmit HIV? 2 hours later
No one in contact with me has developed conjunctivitis that I know of. I was just getting paranoid that I could pass on HIV (even though it was unlikely that I have it in the first place) through my infected eyes. Thank you so much for your patience as I have been extremely anxious.

So to sum and to clarify - there is no risk of passing on HIV through my conjunctivitis to close contacts?

Answered by Dr. Sumit Bhatti 38 minutes later
1. Yes, to conclude: There is no risk of passing HIV through your conjunctivitis to close contacts. Regular precautions are sufficient.
2. Thankfully, the most XXXXXXX human viruses like the HIV and Hepatitis viruses are themselves very fragile. Otherwise the rate of infection would have been 100%!
3. Casual contact never spreads HIV. Examining even a proven patient with unbroken skin is never a problem. Basic care & disposable gloves in handling blood and secretions are enough. Up to 70% patients with HIV present themselves in an ENT OPD.
4. As a doctor and surgeon, I am often faced with this dilemma when examining and operating HIV and Hepatitis B/C positive patients, especially in operations like tracheostomy and mastoid drilling. In such cases, full protective gear including eye protection is mandatory. Plus the stress of infecting yourself or your colleagues and staff with any wrong move with sharp instruments and needles. Hepatitis B is far more contagious as each drop of infected blood can contain more than 10 trillion viral particles!
5. If you feel threatened by HIV, here is a consolation. As Associate Professor at the local institute that bore the brunt of the ICU patients required tracheostomies. Even with a Biohazard Level III 'spacesuit' on, the experience with Swine Flu makes HIV seem like child's play.

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