Can You Get HIV from Needle Sticks? the Risks

Regarding acupuncture?

Hello, doctor.
I would like to ask about the news regarding the incident on the Taiwan Railways where someone was pricked by a syringe.
Is there a risk of HIV infection from being punctured by a syringe like that? Our general understanding of transmission routes is that they involve unprotected sexual intercourse and blood transfusions.
Thank you.

Xiao Lin, 30~39 year old female. Ask Date: 2023/08/13

Dr. Liao Zhongxin reply Internal Medicine

According to the data from the Centers for Disease Control (CDC) in Taiwan, there are three main routes of HIV transmission: A.
Sexual transmission: Engaging in oral, anal, or vaginal intercourse or other exchanges of bodily fluids with an HIV-infected individual carries a risk of infection.
B.
Blood transmission: (1) Receiving or coming into contact with blood or blood products contaminated with HIV.
(2) Sharing needles, syringes, or diluents with individuals who are HIV-positive and use injectable drugs.
(3) Receiving an organ transplant from an HIV-infected donor.
C.
Vertical transmission from mother to child: Infants can acquire HIV from their infected mothers during pregnancy, childbirth, or breastfeeding.
There are two perspectives on the latency period after HIV infection: A.
It is suggested that symptoms resembling a cold may appear approximately 2-6 weeks after infection.
B.
The period from HIV infection to the onset of clinical symptoms is generally 5-10 years (currently referred to as the asymptomatic or subclinical phase).
However, as mentioned earlier, the progression of HIV infection can vary significantly.
During the window or latency period, many patients may be asymptomatic, which can lead to continued engagement in high-risk behaviors, creating gaps in HIV prevention and control efforts.

Reply Date: 2023/08/13

More Info

When it comes to the risk of HIV transmission through needle sticks, it is essential to understand the context and the specific circumstances surrounding such incidents. HIV (Human Immunodeficiency Virus) is primarily transmitted through certain bodily fluids, including blood, semen, vaginal fluids, rectal fluids, and breast milk. The most common routes of transmission are through unprotected sexual intercourse, sharing needles, and from mother to child during childbirth or breastfeeding.

In the case of needle stick injuries, the risk of HIV transmission can vary based on several factors:
1. Source of the Needle: The most critical factor is whether the needle was previously used by someone who is HIV positive. If the needle was used by an infected individual, there is a potential risk of transmission, especially if the needle still contains blood.

2. Viral Load: The amount of HIV present in the blood of the infected person at the time of the needle stick is also crucial. If the individual is on antiretroviral therapy and has achieved an undetectable viral load, the risk of transmission is significantly reduced. This concept is often summarized by the phrase "Undetectable = Untransmittable" (U=U).

3. Time Since Exposure: HIV does not survive long outside the human body. Once exposed to air, the virus becomes inactive within minutes. Therefore, if the needle was not freshly used, the risk of transmission decreases dramatically.

4. Depth of Injury: The depth of the needle stick can also influence the risk. A superficial puncture may carry a lower risk than a deep puncture that draws blood.

5. Immediate Response: If a needle stick occurs, it is crucial to wash the area with soap and water immediately and seek medical attention. Post-exposure prophylaxis (PEP) may be recommended if the source is known to be HIV positive, and it should be initiated within 72 hours of exposure for it to be effective.

In the context of the news about a needle stick injury on a train, if the needle was used by someone who is HIV positive, there is a risk of transmission. However, if the needle was discarded or not freshly used, the risk is significantly lower. It is always advisable to consult with a healthcare professional for an assessment and possible testing if you have concerns about potential exposure to HIV.

In summary, while needle stick injuries can pose a risk for HIV transmission, the actual risk depends on various factors, including the source of the needle, the viral load of the source individual, the timing of exposure, and the depth of the injury. If you ever find yourself in such a situation, seeking immediate medical advice is crucial for proper evaluation and management.

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