needle stick injuries

Question 1

if needle stick injury and child known to be anti-HbAg antibody or HBsag postive

Answer 1

no need to do anything

Question 2

if child not vaccinated against hep B

Answer 2

test for anti-HBAg and HBsAg if results available within 48 hours wait
if not available in 48 hours or both are negative
give HbIG immediately (ideally within 48 hours but not longer than 72 hours)
give one dose of HBV vaccine (ideally within 7 days)
make sure they get the rest of the vaccine series

Question 3

if child vaccinated against hep B completely

Answer 3

test for anti-HBsAg
if results not available in 48 hours give one dose of vaccine

if available and postive no need for further action
if negative
give HBIG and HBV vaccine
test for HBsAg

Question 4

when to consider HIV exposure to needle stick injury high risk and recommend ART

Answer 4

if source known to have HIV, or high prevalence of HIV (if injection drug users are >15% prevalence)
if needle was large bore
if injury with actual blood injection (i.e. deep injury not just superficial scratch)

Question 5

if ART required after a needle stick injury what is the regimen recommended and how long?

Answer 5

28 days

3 drugs

Question 6

reassess needle stick injury at 4 weeks and do what?

Answer 6

give second dose of HBV vaccine if they got their first one at the incident
test for anti-HIV antibody

Question 7

at 3 months follow up for needle stick injury

Answer 7

test for anti-HIV unless previously positive, and HCV antibody

Question 8

at 6 months post needle stick injury

Answer 8

test for anti-HIV, anti-HCV, and anti-HBsAg if not previously positive