Accidental exposure to HIV gets needed attention

As part of the effort,a toll-free 24X7 PEP helpline — 1097 — has been opened (option 6). “It is a one-point line that health officials can consult for any doubts,” said Dr A K Gupta,additional project director of DSACS.

Recently,a special training session for doctors and paramedics was held to explain the nuances of exposure situations. The DSACS has also authorised the distribution of the drugs prescribed by the National AIDS Control Organization (NACO) as per the treatment protocol of PEP to all MCD and government hospitals.

“So far,PEP medication was only available at the Integrated Counselling and Testing Centres,but in order to save time in emergency situations we felt it was ideal if the medicines were made available at all hospitals,” said Dr Gupta.

According to experts,all emergency medicine providers — labour and delivery room personnel,surgeons and OT staff,lab technicians,dentists,mortuary staff and waste handlers — are at possible risk for accidental exposure. “At the training session,we tried to generate awareness about precautions to be taken for needle and stick use and disposal,” said Dr Gupta.

The Delhi government has also initiated a centralised notifying mechanism in case of accidental exposure.

“We have now made it mandatory for hospitals to report staff members complaining of exposure,and their PEP treatment,to DSACS to facilitate a proper registry of accidental exposures,” added Dr Gupta.

Though limited studies have been initiated on this hazard,according to a survey conducted at the Safdarjung Hospital in March last year,among 428 healthcare workers,343 gave a history of needle injuries,and only 40 per cent of the sample knew about the availability of PEP services.

Under the NACO,PEP guidelines outline a protocol for immediate first-aid,counselling and risk assessment of exposed healthcare workers before starting treatment between 2 to 72 hours of exposure. As per the seriousness of exposure,drugs are prescribed for a four-week period,followed by lab investigations and a check-up.

Risk areas
* Percutaneous needle injuries
* Accidental contact with the mucus membrane of eye or mouth
* Contact with non-intact skin
* Exposure to body fluids of infected patient

Categories of Exposure
Mild: Superficial wounds with a low caliber needle
Moderate: Injuries penetrating gloves
Severe: Visible percutaneous injuries with a high-caliber needle visibly contaminated with blood,or accident with a used needle