[Guideline 'Needlestick injuries': risk assessment and post-exposure management in practice]

Guideline 'Needle stick injuries': risk assessment and post-exposure management in practice The objective of the national guideline 'Needle stick injuries' is to make the assessment of needle stick injuries more structured and uniform. The injury is classified as high risk or low risk according to the volume of blood transmitted. For high-risk injuries measures to prevent hepatitis B, hepatitis C and HIV infection have to be considered, whereas for low-risk injuries only measures to prevent hepatitis B. The need for post-exposure prophylaxis is determined by the victim's immunity to hepatitis B and the presence of hepatitis B virus, hepatitis C virus or HIV in the source person. Post-exposure prophylaxis against hepatitis B consists primarily of hepatitis B vaccination; hepatitis B immunoglobulin is added in the case of a high-risk injury with a hepatitis B positive source or a source belonging to a risk group for hepatitis B. In high-risk injuries the victim is tested for hepatitis C and HIV transmission (except in case of a seronegative source). Antiretroviral postexposure prophylaxis is advised for high-risk injuries with a HIV seropositive source or a source belonging to a risk group for HIV.