What Should a Doctor Do After a Needle Prick from an HIV-Infected Individual?

Accidental needle pricks pose a serious risk of occupational exposure to HIV. Immediate action is critical to minimize the likelihood of infection. Here’s a step-by-step guide for healthcare professionals:

1. Remain Calm and Take Immediate Action:
   • Do not panic. Quick and rational action is key.
   • Avoid squeezing the puncture site as this may spread the virus.
2. Wash the Area Thoroughly:
   • Clean the wound immediately with soap and running water.
   • Use an antiseptic solution, if available.
3. Report the Incident:
   • Notify your supervisor or the infection control department in your healthcare facility.
   • Document the incident, including the type of exposure and the source patient’s status.
4. Assess the Risk:
   • Determine the HIV status of the source patient, if not already known. Rapid HIV testing may be necessary.
   • Evaluate the type of exposure (e.g., deep injury, visible blood on the needle).
5. Start Post-Exposure Prophylaxis (PEP) Immediately:
   • Initiate PEP within 1-2 hours of exposure, ideally not later than 72 hours.
   • The standard PEP regimen includes a 28-day course of antiretroviral therapy (e.g., a combination of tenofovir, emtricitabine, and raltegravir or dolutegravir).
   • Consult an infectious disease specialist for guidance on PEP.
6. Follow-Up Testing and Monitoring:
   • Baseline HIV testing should be done immediately after the incident.
   • Repeat testing at 6 weeks, 3 months, and 6 months post-exposure.
   • Monitor for side effects of PEP and manage as necessary.
7. Seek Emotional Support:
   • Such incidents can cause significant emotional distress. Seek counseling or peer support if needed.

Prevention is Key

To minimize occupational exposure, healthcare workers should always:

• Follow standard precautions, including using gloves and proper sharps disposal.
• Attend regular training on handling sharp instruments safely.

Needlestick injuries are a serious but manageable risk in healthcare. Prompt action and adherence to PEP protocols can significantly reduce the likelihood of HIV transmission.