Each year, 600,000 to 800,000 occupatioanl neddlestick injuries are estimated to occur - these can lead to serious or potentially fatal infections with bloodborne pathogens such as hepatitis B virus, hepatitis C virus, or human immunodefieciency virus (HIV). The exact number of injuries is not known because needlesticks often go unreported. Most reported needlesticks involve nurses, but laboratory staff, physicians, housekeepers, dental workers and other heath care workers are also injured.

We think that the risk of infection when exposed to needle puncture or similar injury is 0.32%. The use of zidovudine (a pill taken daily for 4 weeks) is estimated to reduce odds of transmission by 79%. Two other medications may be

Remember, 99.7% of health care providers who are exposed will not be infected even if treatment is not provided.

Factors Predicting Transmission of HIV after Percutaneous Exposure:

Experimental data on efficacy of anti-retroviral treatment:

1. animal models are inconclusive
2. no randomized clinical trials in health care workers have been completed, one is underway now and if you elect to receive anti-retroviral treatment you are encourage to enroll to help those who follow you
3. this treatment has been shown to confer protection in preventing transmission from infected women to offspring

Safety of anti-retroviral treatment:

About 1/3 of people stop because of intolerance of side effects including:

• nausea
• fatigue
• headache
• gastrointestinal dist

If you are offered treatment and elect to take it, you will need to have follow up examinations, blood testing, etc. to be sure that you are doing well and safe.

The Drugs
Zidovudine (AZT, Retrovir) - HIV attacks the immune system and this medicine appears to slow down it’s destruction. It works best when there is a constant amount in your blood. Do Not miss any doses, and do not stop taking this medicine without checking with your doctor first. The most common side effects include fever, chills, sore throat, unusual tiredness or weakness, pale skin. More commonly you may have abdominal discomfort, confusion, convulsions, a general feeling of discomfort, loss of appetite, mood changes, muscle tenderness or nausea. Dose: 200mg by mouth 3 times a day.

Lamivudine( 3TC, Epivir) - This is only used in combination with zidovudine and it weakens the HIV virus’ ability to replicate. Side effects include headache, nausea, malaise, fatigue, diarrhea, and abdominal pain. Gastrointestinal upset and rarely pancreatitis. Dose: 150mg by mouth twice a day.

Indinavir (Crixivan, MK 639) - This drug is added for high-risk exposures and acts on the assembly of HIV particles making them non-infectious. It is usually well tolerated but may cause gastrointestinal upset, a change in your liver blood tests, kidney tests. Dose: 800mg by mouth three times a day.

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