After a percutaneous needlestick injury from a source patient, within what time frame should post-exposure prophylaxis ideally be initiated?

Correct answer: A. As soon as possible, ideally within hours and no later than 24 hours

• A. CORRECT. Post-exposure management is TIME-CRITICAL. HIV PEP should begin ideally within 1–2 HOURS and certainly within 72 hours, but the sooner the better. Hepatitis B immune globulin plus vaccine should be given within 24 hours (and no later than 7 days). Every practice needs a written exposure control plan naming where and how the exposed worker is evaluated immediately — not the next business day.
• B. Thirty days is far too late for any prophylaxis to be effective.
• C. 48–72 hours is the OUTER limit for HIV PEP effectiveness, not the target. Efficacy declines sharply with delay.
• D. Seven days is the outer limit for HBIG in some protocols, but it is far from ideal and is well past the window for HIV PEP.

Note: Immediate steps: wash the site with soap and water, report to the designated supervisor, identify and test the source patient, and get to the occupational health provider the same day.