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Occupational needlestick exposure requiring HIV post-exposure prophylaxis — SCE Acute Medicine MCQ

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HardPublic health and health protectionOccupational needlestick exposure requiring HIV post-exposure prophylaxisSCE Acute Medicine

A foundation doctor sustains a needlestick injury from a hollow-bore needle used on a patient with newly diagnosed HIV and a high viral load. The wound has been washed and occupational health is not immediately on site. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Start HIV post-exposure prophylaxis as soon as possible after risk assessment and baseline bloods

High-risk occupational HIV exposure should be assessed urgently and PEP started as soon as possible, ideally within hours, while baseline testing and follow-up are arranged. Treatment should not be delayed for repeat source testing when the risk is clear. Hepatitis B and C risks also need assessment, but HIV PEP is the time-critical step here.

Reference: UKHSA/BASHH HIV post-exposure prophylaxis guidance; local occupational health policy