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Hi Amanda 1. We would usually do blood for storage at the time of the incident so that any future symptoms or results can be compared to his sample at the time. It is not routinely tested for anything though at the time of the incident. 2. Whether he has PEP or not is dependent on the risk assessment of the situation but should be considered 3. We use the Health Protection Agency recommendation for follow up bloods which are At 6 weeks post injury - test for Hep C rna At 12 weeks post injury - test for Hep C antibody and rna and also for HIV At 24 weeks post injury - test for Hep C antibody I HAVE EXTRACTED THE RELEVANT BIT FROM THE GUIDANCE BELOW "In accordance with HPA's recommendations, HCWs exposed to an HCV positive source should have blood samples taken at the time of the incident (baseline sample), six weeks, 12 weeks and 24 weeks post-exposure. These guidelines also recommend that HCV RNA (genome) testing should be performed on the six week and 12 week serum samples, and that testing for HCV antibodies (anti-HCV) should be carried out on the 12 week and 24 week sera. The stored baseline serum is only tested if a positive result is found, to rule out HCV carriage at the time of exposure. The rationale for the timing of the tests is that, HCV RNA is usually detectable (as early as 10 days after exposure) before the antibodies to HCV develop in the event of a seroconversion and will be positive at six weeks following the exposure, will remain positive whilst viral replication continues and will disappear with spontaneous viral clearance or with sustained virologic response following treatment. Antibodies develop between 50-70 days post-exposure and should be detectable on the 12 week serum sample. At 24 weeks only HCV antibody testing is conducted because around 15% of patients will spontaneously clear the virus. Thus, not detecting HCV RNA at 24 weeks does not exclude HCV infection, only a negative HCV antibody test signifies no previous HCV infection." For more info see http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1227688080528? p=1158945066450 Regards Louise Louise Wade Occupational Health Nurse Consultant Royal Bolton Hospital NHS Foundation Trust Minerva Rd Bolton BL4 0JR 01204-390607 [log in to unmask] -----Original Message----- From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Amanda Savage Sent: 05 January 2009 15:16 To: [log in to unmask] Subject: [OCC-HEALTH] Innoculation Injuries (Unknown Source) Please can I ask my NHS colleagues for advice here. We have a fire fighter who attended an incident and sustained a needle stick injury on Christmas eve. He attended A&E & was given a Hep B booster (although he was already covered) but nothing else. Now its been a while since I worked in the NHS but we used to take bloods & offer 'PEP' has this cahnged? Also I have told him he will need to be screened at 3 months & 6 months for HIV - is this correct as his GP has said 3 months will be sufficient. Ideally I suppose Im looking for some simple guidance that will help both him & me. Can anyone help & Happy New Year to all. ~~~~~~~~~~~~~~~ Please remove this footer before replying. OCC-HEALTH ARCHIVES: http://www.jiscmail.ac.uk/lists/occ-health.html CONFERENCES AND STUDY DAYS: http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH OCCUPATIONAL HEALTH JOBS http://OHJobs.drmaze.net OCCUPATIONAL HEALTH NURSING EDUCATION http://www.aohne.org.uk ******************************************************************** This message may contain information from Royal Bolton Hospital NHS Foundation Trust which is confidential or privileged. If you are not the intended recipient, please advise the sender immediately by reply e-mail and delete this message and any attachments without retaining a copy. Should you have any questions please reply to: [log in to unmask] ******************************************************************** ~~~~~~~~~~~~~~~ Please remove this footer before replying. OCC-HEALTH ARCHIVES: http://www.jiscmail.ac.uk/lists/occ-health.html CONFERENCES AND STUDY DAYS: http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH OCCUPATIONAL HEALTH JOBS http://OHJobs.drmaze.net OCCUPATIONAL HEALTH NURSING EDUCATION http://www.aohne.org.uk