Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.
Postexposure prophylaxis for HIV.
AIDS Clin Care. 1997 Aug;9(8):59-61, 66. Unique Identifier : AIDSLINE MED/97702767 Daily JP; Clearinghouse, AIDS Newsletter Database, P.O. Box 6003, Rockville, MD; 20849-6003. 800-458-5231 ext. 5714. A fee will apply.; Brigham and Women's Hospital, Boston, MA.
Abstract:
Postexposure prophylaxis represents an advance in the management of percutaneous exposure to HIV in the workplace, but its efficacy in other settings needs further study. Three types of occupational exposure, percutaneous, mucous membrane, skin contact or loss of skin integrity, the postexposure prophylaxis to be used or offered, and the risk data and assessment for HIV acquisition are examined. Analysis of HIV transmission through percutaneous exposure reveals that occupational risk for health care workers is increased by deep injury to the exposed worker, visible blood on the injuring device, exposure of the device to source patients' vein or artery, and source patient's death from AIDS within 60 days of the accident. Prophylaxis for percutaneous exposure, if indicated, should be initiated within 1 to 2 hours to be effective. HIV antibody titers should be measured immediately and at 6 weeks, 12 weeks, and 6 months after exposure. AZT prophylaxis following percutaneous occupational exposure has dramatically decreased transmission in this setting and multiple drug regimens have become the standard of care to further increase efficacy. Sexual contact is the most frequent means of transmitting HIV infection and reducing exposure is the mainstay of public health efforts. Prophylaxis after non-occupational exposures such as sexual intercourse or sharing needles could potentially decrease transmission, although efficacy has not yet been demonstrated. Routine prophylaxis after sexual exposure may be an ineffective strategy.
Keywords: *Disease Transmission, Patient-to-Professional *HIV Infections/PREVENTION & CONTROL 971230
M97C1557
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