Post exposure prophylaxis for healthcare workers after needle stick injury, cut on finger exposed to soil management

Question 1

What to do immediately after exposure?

Answer 1

1. Wash skin with soap and water
2. Flush mucous membrane with water
3. Do not stop the bleeding
4. Report exposure
5. Take 300 mg retrovir (if available)
6. Seek advice of infectious disease specialist
7. Provide blood sample form source of exposure and exposed person for serological tests.

Question 2

Which serological tests will you do?

Answer 2

1. Hepatitis B: anti-HBs antigen
2. Hepatitis C: EIA/ ELISA for anti-HCV antibodies, PCR in neonates
3. HIV: ELISA with anti- HIV antibodies

Question 3

Indications for PEP for HIV?

Answer 3

• Injury with HIV- contaminated instruments or needles
• Contamination of open wound or mucous membrane with HIV- contaminated fluids
• Unprotected sexual activity with a know or potentially HIV- Infected person.

Question 4

What to do ASAP when exposed to HIV?

Answer 4

ASAP: Start treatment within 72 HOURS after exposure

Question 5

What treatment is used for HIV exposure?

Answer 5

Antiretroviral treatment:
Tenofovir/ Emtricitabine (truvada) or Zidovudine/lamivudine (combivir) + lopinavir or raltegravir
- 1-2 tablets daily for 28 days.

Question 6

In newborn and children exposed to HIV?

Answer 6

Less than 10 years with infected mother : Lamivudine + zidovudine + ritonavir-booster lopinavir

Question 7

Pregnant women exposed to HIV

Answer 7

• Prevention of transmission to child
• the risk of transmission is proportional to viral load of the mother
• Antiretroviral therapy is used for mothers before and during delivery and for mothers and infants after the delivery
• caesarean section has lower risk of transmitting HIV than vaginal delivery
• HIV could also be transmitted via breastfeeding and thats why breastfeeding infants should receive antiretroviral PPX