A healthcare worker experiences a needlestick injury; which action should the infection preventionist recommend?

• A. Test the source patient for HCV RNA or antibodies at the time of exposure.
• B. Quarantine the healthcare worker for six weeks and test for all infections.
• C. Treat the healthcare worker with antiviral agents immediately without testing.
• D. Ignore the exposure unless symptoms develop.

Answer: (A)

The main idea here is that quickly determining the source’s infection status guides all subsequent management after a needlestick. Testing the source patient for HCV RNA or antibodies at the time of exposure provides essential information about whether the worker’s risk is real and what follow-up is needed. If the source is infected, the clinician can set up baseline testing for the exposed worker and plan appropriate serial follow-up to detect any seroconversion, since there is no proven post-exposure prophylaxis for HCV. If the source is not infected, the risk is lower and follow-up can be more limited.

This approach avoids unnecessary treatments and interventions and ensures monitoring is based on actual risk. Quarantining the worker, starting antiviral therapy immediately without testing, or ignoring the exposure until symptoms develop are not appropriate responses, as they either overreact, are not indicated for HCV exposure, or delay detection and care.