Preventing
exposures to blood and body fluids (i.e., primary prevention) is the most important
strategy for preventing occupationally acquired human immunodeficiency virus
(HIV) infection. Healthcare personnel
(HCP) should adhere to the principle of Standard Precautions, including
consistent use of appropriate work practices, work practice controls, and
personnel protective equipment (PPE).
Healthcare
personnel should be aware of the recently published U.S. Public Health Service
Guidelines for the Management of Occupational Exposures to Human Immunodeficiency
Virus and Recommendations for Postexposure Prophylaxis [PEP] (http://www.jstor.org/stable/full/10.1086/672271). This report continues to emphasize the
following:
- Primary prevention of occupational exposures
- Prompt management of occupational exposures, and, if indicated, initiation of PEP
- Selection of PEP regimens that have the fewest side effects and that are best tolerated by prophylaxis recipients
- Anticipating and preemptively treating side effects commonly associated with taking antiretroviral drugs
- Attention to potential interactions involving both drugs that could be included in HIV PEP regimens and medications that PEP recipients might be taking
- Consultation with experts on PEP management strategies
- HIV testing of source patients (without delaying PEP initiation in the exposed provider) using methods that produce rapid results
- Counseling and follow-up of the exposed HCP
Recommendations
included in this report may be summarized as follows:
