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Sharps Injury Unknown Source — SCE Infectious Diseases MCQ

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EasyInfection Prevention & ControlSharps Injury Unknown SourceSCE Infectious Diseases

A 35-year-old healthcare worker sustains a sharps injury from a hollow-bore needle used on a patient with unknown blood-borne virus status. The source patient declines testing. What BBV PEP should be offered?

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Correct answer: C — HIV PEP should be offered based on risk assessment (hollow-bore needle = significant exposure); HBV — check the healthcare worker's vaccination status and anti-HBs titre; HCV — no PEP exists, but baseline and follow-up HCV RNA should be sent

When the source patient declines testing: HIV PEP should be offered based on risk assessment (hollow-bore needle from a patient of unknown status is generally considered a significant exposure warranting PEP in practice). PEP: DTG/TDF/FTC for 28 days, started within 72 hours (ideally within 1 hour). HBV: check the HCW's vaccination status and anti-HBs titre; if non-immune (anti-HBs <10) or unvaccinated, give HBIG plus accelerated HBV vaccine course. HCV: no PEP exists; baseline HCV RNA at time of injury and follow-up at 6 and 12 weeks.

Reference: BHIVA/BASHH 2021 – PEP guidelines; UKHSA 2024 – BBV exposure; Green Book Ch 18