Needle stick injury
Last updated: Thursday, 23, December, 2010
|Key Information||Appropriate Tests|
Assessment of health care worker or patient, contaminated with blood or body fluids via
Exposed and/or injured individual should have baseline testing for previous or active infection with hepatitis B (hepatitis B virus testing for anti-HBs, HBsAg, anti-HBc IgG, as appropriate), hepatitis C (hepatitis C virus [HCV] antibodies) and HIV (HIV antibodies).
Boosting of immunity for hepatitis B is usually performed (after blood has been taken for baseline testing) with hepatitis B vaccine or hepatitis B hyperimmune globulin (as appropriate).
Testing should be repeated at 3 and 6 months. If the source of the exposure is positive for hepatitis C (HCV) RNA, earlier testing, eg at 1 month, of the exposed individual for hepatitis C RNA should be considered.
Investigation of source of contaminating blood/body fluid
The individual from whom the contaminating blood or body fluids was derived should be tested for infectivity by determining HBsAg, HCV and HIV antibody status immediately.
Negative results do not exclude the possibility of infectivity. Counselling and consent required.
Further tests will depend on results of HBsAg, anti-HCV, anti-HIV.
HBeAg testing to determine magnitude of risk of hepatitis B infection in a non-immunised or non-immune worker or patient.
If contaminated blood is HBeAg positive, the risk of seroconversion is up to 60%; if negative, the risk is between 10 and 20%.
The seroconversion risk is considered to be between 3 and 5%.
Hepatitis C (HCV) RNA provides a clearer indication of the infective risk.
Risk depends on the stage of disease in the individual from whom blood was derived and the amount of blood accidentally inoculated.