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The following review tries to show some practical guidelines and the steps to follow after laboral exposure of the cited viruses. The risk of infection is directly related to the degree of exposure to blood on the work site and the amount of Hepatitis B antigen on the source.
The Hepatitis C virus is not transmitted efficiently through direct exposure with infected blood. The presence of HIV antibodies after an accidental percutaneous exposure is about 1.8% (0.7%). In the absence of a post-exposure prophylaxis for Hepatitis C, recommendations on patient handling for these cases are based on obtaining identification of the chronic disease, and if present, refer to recommended therapeutic treatments.
The risk of transmission after percutaneous exposure to HIV-infected blood has been set to be approx. 0.3% IC 95% (0.2-0.5%); through mucous membrane exposure around 0.09% IC 95% (0.06-0.5%). The risk after exposure to nonintact skin has not been quantified; therefore, it should not be considered lower than that of mucous exposure. The risk of HIV transmission is found in individuals clearly exposed to contaminated blood, a deep inoculation, or a procedure that involves a vein or artery in a direct way. The risk also rises when the blood comes from a terminally infected patient, due to the high concentration of HIV. The plasmatic viral load directly reflects the levels of free virus on surrounding blood. A viral load of 1500 copies/ml of RNA indicates probably low levels of exposure but does not exclude the possibility of transmission.
