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Testing Employee After BBP Exposure

Q: We had a needlestick employee exposure yesterday. We obtained the source patient's blood for testing, including a STAT Rapid HIV test. What about the employee's baseline blood sample? How many hours post-exposure must this blood draw occur by?

A: The U.S. Public Health Service Guidelines for the Management of Occupational Exposures for HIV (MMWR Recommendations and Reports: Sept 30, 2005) and for HBV and HCV (MMWR Recommendations and Reports: June 29,2001) do not specifically mention a time deadline for obtaining the employee baseline blood sample.

It stands to reason that the sample should be obtained before the employee could seroconvert from the exposure. Incubation times are shown below:

HIV: 6 -- 12 weeks
HBV: 8 -- 12 weeks
HCV: 6 -- 9 weeks

We encourage you to obtain consent from the exposed employee to take a blood sample to be tested as soon as possible after the exposure incident. Experts at the National Clinicians' Post-Exposure Prophylaxis Hotline advised that the employee baseline blood sample could be drawn up to 2 weeks after the occupational exposure.

Even after their blood is drawn, the exposed employee need not make an immediate decision about having their blood tested for HIV, HBV and HCV. Ninety days are given after the baseline blood sample is collected to decide whether or not to test. If the employee decides against immediate testing, ensure the blood sample is preserved for 90 days.

If the source patient's results are negative for HIV, Hepatitis B and Hepatitis C there is no need to test the employee's blood since the employee couldn't become infected. If the source patient's negative results are back and the employee's blood has not yet been drawn, there is no reason to perform a draw. Conversely, if the employee's blood has been drawn and retained it can be discarded without testing (if source patient is negative for HIV, HBV and HCV).

For more information on post-exposure procedures, refer to Tab 5 of the Quality America OSHA Safety Program Manual.

Posted by Quality America on March 8, 2007 | Comments (0)


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