Overview

This document gives practical step by step guidance on what to do after potential exposure to blood-borne viruses (BBV) following a needle-stick or other exposure.

It covers injuries sustained by:

• NHS health-care workers (HCW)
• Third sector workers in voluntary agencies providing BBV testing using dry blood spot tests
• Non-occupational injuries

NB: The Occupational Health Service (OHS) ONLY deals with injuries of HCWs

Individuals presenting after sexual exposure or assault should be assessed according to the Post-Exposure Prophylaxis for Sexual Exposure (PEPSE) and non-occupational exposure to Blood Borne Viruses.

Anti HBs − Hepatitis B Surface Antibody
BBV − Blood-Borne Virus
CSHC − Chalmers Sexual Health Centre
GUM − Genito-Urinary Medicine
HBIG − Hepatitis B Immunoglobulin
HBV − Hepatitis B Virus
HCV − Hepatitis C Virus
HCW − Health Care Worker
HIV − Human Immunodeficiency Virus
ID − Infectious Diseases
OHS − Occupational Health Service
PCR − Polymerase Chain Reaction
PEP − Post Exposure Prophylaxis
RHCYP − Royal Hospital for Children and Young People
RIDU − Regional Infectious Diseases Unit
RIE − Royal Infirmary of Edinburgh
SJH − St John’s Hospital
WGH − Western General Hospital

Needlestick injury immediate care and BBV risk assessment flowchart

Recommendation for how to optimally manage a needlestick injury, including assessment for each BBV; also available in section Immediate care and risk assessment.

BBV exposure risk assessment form

To be filled out in every case, and forwarded to the relevant specialty in cases of significant exposure.

Blood borne viruses – Background information for risk assessment

Allows you to calculate percentage chance a source is BBV positive, to perform a risk assessment.

Current recommended HIV post-exposure prophylaxis (PEP)

Current NHS Lothian recommended PEP medication.

Needlestick injuries and prevention of HIV infection: A factsheet for patients

Information about risk of contracting BBVs from needlestick, BBV testing and PEP.

Post exposure prophylaxis (PEP) antiretroviral starter pack: Patient information leaflet

PEP patient information leaflet. Give to patients who are starting PEP.

Testing for blood borne viruses: Information for patients

Can be handed to patients who are or are considering being tested for BBV.

1. Department of Health and Social Care. EAGA guidance on HIV post-exposure prophylaxis - Updated guidance on occupational HIV post-exposure prophylaxis (PEP) from the UK Chief Medical Officers' Expert Advisory Group on AIDS (EAGA). 2008, updated 2015. 
2. BMA. Needlestick injuries and blood borne viruses: decisions about testing adults who lack capacity. 2016, updated April 2023.