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needle prick injury - exposure to HIV
Feb 20, 2008

I am a health worker & have just pricked myself after giving IM injection to HIV +ve patient. No blood was oozing from my finger. What needs to be done next? Shall I start anti-retroviral therapy rightaway. Pl. advise.

Response from Dr. Frascino

Hello,

As a health care worker I would hope you would know exactly what to do in the case of an occupational exposure. It should have been an important part of your medical training and orientation to your current position wherever it is in the field of medicine and health care!

All health care facilities have policies and procedures in place to respond quickly to these situations. In case you've forgotten, you need to report and document your exposure at the occupational medicine division (or its equivalent). There you will be thoroughly evaluated and blood will be drawn for baseline tests for HIV (and hepatitis if indicated). PEP will be prescribed, again if indicated, and follow-up arrangements with an HIV specialist will be made. The HIV specialist will further document your risk, optimize your PEP regimen, evaluate and manage any PEP-related side effects or toxicities and arrange for an interpret all post-PEP HIV screening tests.

Don't hesitate. PEP is most effective when begun as soon as possible (and no later than 72 hours) after exposure.

The link to the Updated U.S. Public Health Services Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Post-Exposure Prophylaxis is:

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm Good luck.

Dr. Bob



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