Post-exposure Prophylaxis : What Every Health Care Worker Should Know

Most health care workers (HCW) working around patients or biological samples stand the risk of accidental exposure to blood and blood-borne pathogens or contact with mucous membrane or damaged skin. The risk of infection after an exposure is dependent on a number of variables. After percutaneous injury, the risk of infection varies with the pathogen [1, 2, 3]. Dual infections are also known to occur [6]. If the source patient is positive for both HBsAg and HBeAg, the risk of Hepatitis B transmission is approximately 37-62%. If the source patient is positive for HBsAg but is HBeAg negative the risk of Hepatitis is lower- approximately 23-37% [2, 3, 4]. If the source patient has Hepatitis C infection the risk of transmission is approximately 1.8% (range 0-7%) [1, 2, 3, 5, 6]. The risk of HIV transmission is approximately 0.3% after a percutaneous exposure and 0.09% after a mucous membrane exposure if the source patient has HIV infection [1, 7, 8]. The risk of transmission of infection is higher with exposure to blood especially in advanced disease; prolonged exposure of even non-intact skin/ mucous membrane to blood or other infectious fluid; cut with a contaminated device drawing blood and injury with a hollow-bore, blood-filled needle.