This document outlines precautions that should be taken when handling cases infected with HIV or hepatitis B. It discusses suspecting factors for HIV infection and recommends vaccinating staff against hepatitis B. Special precautions are needed at crime scenes, during autopsies, in laboratories, and in courts when handling biological material. Proper use of protective equipment, cleaning and disposal procedures, accident protocols, and preventing contamination are emphasized. The overall message is that prevention is the best way to control the spread of HIV and hepatitis B.

1. HANDLING
HIV
INFECTED
AND
HEPATITIS-B
POSITIVE CASE

2. A POWER POINT PRESENTATION
BY
DR.SANGEETA CHOWDHRY
&
DR.SUNIL SHARMA
DEPARTMENT OF FORENSIC MEDICINE
&
TOXICOLOGY
GOVT. MEDICAL COLLEGE
JAMMU (JAMMU AND KASHMIR)

5. THOUGH IN DISTANT TIME, YOU MAY NOT LOVE ME SO;
I SHALL ALWAYS KEEP YOU CLOSE AND NEVER LET YOU GO.

7. SUSPICION OF HIV
HIV should be suspected if the
body is of
A male homosexual
An intravenous drug abuser
A haemophiliac who has received
repeated blood transfusions
A female prostitute
A victim of sex abuse

8. A MALE HOMOSEXUALMALE HOMOSEXUAL

9. AN INTRAVENOUS DRUG ABUSER

10. A HAEMOPHILIAC WHO HAS RECEIVED REPEATED
BLOOD TRANSFUSIONS

11. A FEMALE PROSTITUTE

12. A VICTIM OF SEX ABUSE

13. PRECAUTIONS FOR STAFF
All staff working in close association
of HIV patients should be:-
Vaccinated against Hepatitis-B
Re-vaccinated at intervals when the
body titres falls below protective level
Avoid direct contact with of skin and
mucous membranes with body fluids
and tissues
Hands should be washed after each
activity with soap and water even if
gloves are worn

14. SPECIAL PRECAUTIONS ARE MANDATORY
At the scene of crime
In the autopsy room
In the laboratory
In the court
General precautions

15. AT THE SCENE OF CRIME

16. Disposable shoe protection by person at the
scene of crime
Foods or smoking should not be allowed at
the scene of crime
Blood-contaminated clothing or any other
material should be handled carefully. Dried-
blood or wet blood material that is not to used
as evidence should be decontaminated and
properly disposed off by incineration.
Non-disposable material used during the
investigation and collection of the evidence
should be decontaminated by usual
hypochlorite solution
AT THE SCENE OF CRIME

17. IN THE AUTOPSY ROOM

18. IN THE AUTOPSY ROOM
Admission:-no unauthorised person should be
allowed in the autopsy and body preparation room
Clothing:-all protective gears, (to completely
cover the body) like wearing double
gloves, gowns, water-proof
apron, caps, masks, goggles if eye glasses are not
worn, and shoe cover
Instruments:- minimum instruments should be
kept. To start with; scalpel, scissors, knife and
artery forceps should be used. The instruments
should be slightly blunt unless required to avoid
any injury to the working hand
cont....................

19. Disposal requirement:-all material/protective gears
used during the autopsy must be disinfected, sterilised
or incinerated as applicable
Handling specimens for laboratory purposes:-at all
times during autopsy; gloves should be worn by all the
persons working with these suspected cases.
Clean –up procedure:- all splatters and spills of blood
and other body fluid should be wiped with disposable
tissues or towels which can be discarded in bio-hazard
bags and properly disposed off and the area be cleaned
with disinfectant.
cont.................
IN THE AUTOPSY ROOM

20. IN THE AUTOPSY ROOM
Disinfection:- a solution of 1:10 dilution of household bleach
or freshly prepared solution of sodium hypochlorite
(equivalent to5000ppm) should be used
Accidental injury or prophylaxis:- in case of any mishap
resulting in injury; matter should be reported to the
concerned authorities after proper disinfection of the wound.
Blood sample should be taken from the site of exposure of
wound and from the injured person for immediate testing of
HIV and Hepatitis-B and keep these records for follow
up/comparison at an interval of 6weeks, 3 months,6 months
and 1 year. All suspected exposed cases of HIV should be
given ZIDOVUDINE, 500mgms x twice a day x 6 weeks.
Persons exposed to Hepatitis-B and who have not been
prophylactically vaccinated for it; must be given Hepatitis-B
immunoglobulin within 72 hours of the incident , followed by
active vaccination.

21. IN THE LABORATORY

22. Disposable gloves should be worn and counter
top cover used in areas where biological
material is examined. They should be disposed
off properly.
Food or smoking should not be allowed in the
working area
All biological specimens should be considered
as contaminated and disposed off properly
Mouth-pipetting of biological material should
not be practised
All specimens should be destroyed by burning
or chemically decontaminated
Hands should be washed before leaving the
work area
IN THE LABORATORY

23. IN THE COURT

24. Whenever possible, all biologically
contaminated material should be referred by
photographic or other means rather than
presenting in the court
Whenever necessary bullets, clothing, etc
should be handled using disposable gloves
and paper, or the (dry-not wet/moist)
evidence should be enclosed in a
sealed, clear, plastic bag
Hands should be washed after handling
the evidence
IN THE COURT

25. GENERAL PRECAUTIONS

26. Prevention is better than curement. The best way to control
dissemination of HIV and Hepatitis-B is prevention which includes
:-
 Avoiding unnecessary contamination of the work area, keeping
things need and clean, restricting the flow of water and other fluids
within the limited bounds of the work area
 Minimising and taking care of injuries
 Create an atmosphere of free aerosol of biological material
such as that produces saw during autopsy. Use of dustless saw is
the need of the hour.
 All efforts should be made to tackle all type of contamination
which includes washing of hands, cleaning floor, doors, door
knobs, telephone apparatus/mobiles etc. with a disinfectant of
killing viruses and thereby protecting the health workers.
GENERAL PRECAUTIONS

28. THANK YOU
ABC OF AIDS
A-AVOID UNSAFE SEX
B-BE FAITHFUL TO YOUR SPOUSE
(and if not possible; use)
C-CONDOMS