Needle stick injury

Last updated: Thursday, 23, December, 2010
Key InformationAppropriate Tests

Assessment of health care worker or patient, contaminated with blood or body fluids via

See also Hepatitis B virus infection
Hepatitis C virus infection
HIV infection

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.

  • Ingestion
  • Needle, other sharps
  • Splashes on mucosal surfaces (for example conjunctiva)

Investigation of source of contaminating blood/body fluid

  • Unknown status 

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.

  • Known to be HBsAg positive 

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%.

  • Known to be HCV antibody positive 

The seroconversion risk is considered to be between 3 and 5%.

Hepatitis C (HCV) RNA provides a clearer indication of the infective risk.

  • Known to be HIV antibody positive 

Risk depends on the stage of disease in the individual from whom blood was derived and the amount of blood accidentally inoculated.