Needlestick / exposure prophylaxis

• HIV (start within 72 h): TDF + 3TC + DTG (TLD)
• Hepatitis B (unvaccinated / non-responder): Hepatitis B immunoglobulin, Hepatitis B vaccine

Start HIV PEP within 72 h (ideally 2 h) — do not wait for results.

First visit

• Source: HIV, HBsAg, anti-HCV — Test the source patient with consent; rapid HIV test if available.
• Exposed person: HIV, HBsAg, anti-HBs, anti-HCV — Baseline, the same day.
• CBC, creatinine, LFT — Baseline before tenofovir-based PEP.
• Urine pregnancy test — Women of child-bearing age.

Follow-up and monitoring

• HIV test at 6 weeks and 3 months — After the exposure.
• Anti-HCV / HCV RNA and LFT — At 3–6 months if the source is HCV positive or unknown.