Injection equipment and transfusion related Route of HIV Transmission

(World Patient Safety Day)

To inject means using a syringe and needle to introduce drugs or fluid into the body for various purposes. It is a method of introducing drugs through the skin whether intravenously, intramuscularly, subcutaneously etc. It is a parenteral route of administering substance into the body outside of the digestive tract (non-oral). This may either occur in the hospital setting under medical supervision or outside of it, by drug users. 

When a substance is injected, it bypasses the first pass metabolism in the liver which results in higher bioavailability. Also important is that the full effects are felt within five to ten seconds as the parenteral route is a route of administration with a fast onset of action. The person gets a stronger (though shorter acting) effect when compared to oral route. 

The use of injections is one of the mainstays in the healthcare setting. Whether for drug administration or collecting blood samples for investigations, injections are frequently used in the hospitals. This therefore increases the risk of transmission of infections by injection route putting the safety of patients and sometimes healthcare workers at risk. Poor injection practices are the reason for this risk. Many injections may be unnecessary and even unsafe. Of most concern is reuse of injection equipment in the absence of sterilisation. Injection equipment should not be reused but if they absolutely have to be, then they must be sterilized. 

Sterilisation makes use of different methods to inactivate viable microorganisms present within the injection equipment. 

Blood transfusion procedures are another area of concern with HIV transmission as blood is a very efficient means of transmitting the virus. It has been estimated that around 10% of AIDS cases in developing countries result from blood transfusion.

HIV can be transmitted through these procedures if utmost care is not taken and routine tests are properly carried out. The risk involved depends on factors like the prevalence of HIV viremia in the donor population, the likelihood of blood donation before HIV antibodies are detected in blood (window period), the sensitivity of the screening test (in presence of detectable antibodies) and the units of blood received from the donor. People who routinely receive multiple transfusions of blood and blood products, such as individuals living with blood diseases like sickle cell anemia, are at greater risk of HIV infection than the general population. 

17th September, World Patient Safety Day, emphasizes the utmost priority of safeguarding the patients’ lives especially during the medical care phase. Healthcare professionals all over the world must ensure that patient safety is prioritized to prevent HIV transmission during blood transfusion procedures. 

Conclusion

Patient safety precautions must be top-of-mind at all times so that healthcare professionals do not contribute to the already rising risk of HIV infections from healthcare sources.