From the Guidelines
A person can contract HIV from a needlestick injury even if they don't currently have HIV. When a needlestick occurs with a needle contaminated with HIV-positive blood, there is approximately a 0.3% risk of HIV transmission, as noted in the guidelines for the management of occupational exposures to HIV 1. If exposure occurs, post-exposure prophylaxis (PEP) should be started as soon as possible, ideally within 72 hours. The standard PEP regimen typically includes a combination of antiretroviral medications such as tenofovir disoproxil fumarate plus emtricitabine (Truvada) plus dolutegravir (Tivicay) taken for 28 days.
The risk of transmission depends on several factors including:
- The depth of injury
- Visible blood on the device
- Whether the needle was in an artery or vein of the source patient
- The viral load of the source patient Other bloodborne pathogens like hepatitis B and C can also be transmitted through needlestick injuries. Healthcare workers and others at risk should follow universal precautions, including proper handling and disposal of needles, to prevent such injuries, as recommended by the updated U.S. public health service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis 1.
Key considerations for managing occupational exposures to HIV include assessing the nature of the exposure and the amount of blood or body fluid involved, as well as the infectivity of the exposure source, as outlined in the public health service guidelines for the management of health-care worker exposures to HIV and recommendations for postexposure prophylaxis 1. However, the most recent and highest quality study, which is the updated U.S. public health service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis 1, provides the most relevant guidance for current practice.
From the FDA Drug Label
Avoid doing things that can spread HIV-1 infection to others. Do not share or re-use needles or other injection equipment. The FDA drug label does not answer the question.
From the Research
Risk of HIV Transmission from Needle Stick Injury
- The risk of HIV transmission from a needle stick injury is a concern for healthcare workers, even if the patient does not have HIV, as the needle may have previously come into contact with infected blood or other bodily fluids.
- According to a study on post-exposure prophylaxis 2, seroconversion to HIV-1 can still occur despite combination post-exposure prophylaxis after a needlestick injury.
- Another study on needlestick injuries and safety syringes 3 highlights the risk of infection by blood-borne diseases, such as hepatitis and HIV, from needlestick injuries.
Post-Exposure Prophylaxis
- Post-exposure prophylaxis (PEP) with antiretroviral drugs is a recommended course of action after high-risk exposures, including needlestick injuries 4.
- A study on a novel 3-drug PEP regimen consisting of raltegravir, tenofovir DF, and emtricitabine found that none of the 85 evaluable participants became HIV infected after completing the regimen 4.
- However, the effectiveness of PEP depends on various factors, including the type of exposure, the viral load of the source patient, and the timing and adherence to the PEP regimen.
Prevention of Needle Stick Injuries
- The use of fixed-needle safety syringes is one measure that can be taken to minimize the risk of needlestick injuries 3.
- However, some healthcare workers may refuse to use such devices, highlighting the need for education and training on the importance of safety protocols in preventing needlestick injuries.