He was drug naïve with CD4 cell count 460 cells/mm 3. A diagnosis of acute HIV infection was considered and TDF+FTC+EFV were started as per DHHS guidelines.Īs the sensorium improved, details from patient revealed that his foster son (Mr.X) who was HIV-1 positive, due to heterosexual acquisition. A) did not provide any history of unprotected sex or multiple sex partners, nor any intravenous drug use in past or present, His spouse is HIV negative, The HIV-I viral load on the 4 th day of hospitalization was >750,000 copies/ml (Cobas Taqman 48 Real time PCR) and The CD4 + cell count was 396 cells/mm 3. Computerized tomography (CT) Brain showed nonspecific changes. A clinical diagnosis of malaria, metabolic encephalopathy with sepsis was made, later the patient had two episodes of generalized tonic-clonic convulsions and was treated with midazolam and Loarazepam followed by phosphenytoin along with IV Artesunate. On 29 March 2010, a 44 year's old man (Mr.A) a known case of NIDDM (Non-insulin dependent diabetes mellitus) and hypertension for past four years under treatment was brought to the hospital with history of high grade fever and increasing drowsiness for past four days.Ĭlinical examination revealed a drowsy febrile patient without focal neurological deficit or meningeal signs. Hence it is necessary to treat the HIV infected human bites with post exposure prophylaxis. The family physician should have taken PEP decision after proper evaluation of the severe and bleeding bite. The recipient did not receive PEP as his family physician was unaware of salivary transmission. The blood and saliva of the source and blood of the recipient showed a detectable viral load with 91% sequence homology of C2-V3 region of HIV gp120 between the two individuals. The case presented here is of a primary HIV infections following a human bite where in the saliva was not blood stained but it got smeared on a raw nail bed of a recipient. The HIV infected individuals have more viruses in blood than saliva, possibly due to the potent HIV-inhibitory properties of saliva. The oral tissues support HIV replication and may serve as a previously unrecognized HIV reservoir. There are anecdotal reports of HIV transmission by human bites particularly if saliva is mixed with blood. The potential risk of HIV-1 infection following human bite although epidemiologically insignificant, but it is biologically possible.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |