Needle Stick Injuries

Needle-stick injuries are common among health care professionals. Like other puncture wounds, these injuries carry the risk of bacterial infection in addition to the risk of infection with hepatitis and human immunodeficiency virus (HIV). The risk of infection after an inadvertent needle stick from an infectious source has been estimated to be negligible for hepatitis A virus (HAV), 9 percent (range 5 to 27 percent) for hepatitis B virus (HBV), 1.8 percent (range 0 to 7 percent) for hepatitis C virus (HCV), and 0.3 percent (range 0.2 to 0.5 percent) for HIV. 12,13 and 14

Preexposure prophylaxis is currently possible for HAV and HBV with appropriate vaccines.12 Postexposure prophylaxis is possible for HAV with immune serum globulin (ISG), for HBV with hepatitis B immune globulin (HBIG), and for HIV with combination antiviral therapy. 1 1 and 14 There is no proven postexposure prophylaxis for HCV.13 Many factors enter into the decision process concerning the risks and benefits of treatment: (1) location of the needle stick, (2) ability to test the source, (3) immune status of the recipient, and (4) time from injury until treatment. Recommendations in this area are complex and changing. Each hospital should have a predesigned protocol developed by infectious disease specialists for the expeditious evaluation, testing, and possible treatment of needle-stick injuries.

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