Accidents d'exposition au sang : conduite à tenir

The risk of transmitting HIV, HCV and HVB by occupational contamination depends upon the exposition circumstances. Recommendations concerning decision making in such situation have been distributed by ministerial documentation. No case of HIV seroconversion has been reported since 1997 (the risk since 1995 is evaluated at 0.32%). On the other hand, 8 new cases of HCV infection have been reported and documented since 1998 (risk evaluated at 2.1%). The mandatory vaccination of all health care personal (HCP) against HBV has theoretically eliminated all risk in the medical field. Establishing post-exposure of anti-HIV chemoprophylaxis, taking into account different factors (the exposure severity, treatment delay, serological status of the source patient), have been generalized. No failures of such chemoprophylaxis have been reported since 1997. The existence of non-responders or of poor responders (about 10%) to HBV vaccination requires systematic evaluation of the risk and the realisation of serovaccinations as early as possible. Regarding HCV, the serological status of the source patient determines decision making when seeking for asymptotic primo-infection, in order to consider treatment by Interferon-Ribavirine in a specialized environment.