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POST-EXPOSURE PROPHYLAXIS
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last updated: June 29, 2001
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COMPLETE GUIDELINES:
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RELATED INFORMATION:
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faqsnewslinks
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Occupational Exposure Management Resources
Several resources are available that provide guidance to HCP regarding
the manage-ment of occupational exposures. These resources include
PEPline; the Needlestick! website; the Hepatitis Hotline; CDC (receives
reports of occupationally acquired HIV infections and failures of
PEP); the HIV Antiretroviral Pregnancy Registry; FDA (receives reports
of unusual or severe toxicity to antiretroviral agents); and the
HIV/AIDS Treatment Information Service (Box 5).
BOX 4. Situations for which expert* consultation for HIV postexposure
prophylaxis is advised
- Delayed
(i.e., later than 24-36 hours) exposure report
- the interval after which there is no benefit from postexposure
prophylaxis (PEP) is undefined
- Unknown
source (e.g., needle in sharps disposal container or laundry)
- decide use of PEP on a case-by-case basis
- consider the severity of the exposure and the epidemiologic
likelihood of HIV exposure
- do not test needles or other sharp instruments for HIV
- Known
or suspected pregnancy in the exposed person
- does not preclude the use of optimal PEP regimens
- do not deny PEP solely on the basis of pregnancy
- Resistance
of the source virus to antiretroviral agents
- influence of drug resistance on transmission risk is unknown
- selection of drugs to which the source person's virus
is unlikely to be resistant is recommended, if the source
person's virus is known or suspected to be resistant to
>1 of the drugs considered for the PEP regimen
- resistance testing of the source person's virus at the
time of the exposure is not recommended
- Toxicity
of the initial PEP regimen
- adverse symptoms, such as nausea and diarrhea are common
with PEP
- symptoms often can be managed without changing the PEP
regimen by prescribing antimotility and/or antiemetic agents
- modification of dose intervals (i.e., administering a
lower dose of drug more frequently throughout the day, as
recommended by the manufacturer), in other situations, might
help alleviate symptoms
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*Local experts and/or the National Clinicians' Post-Exposure Prophylaxis
Hotline (PEPline [1-888-448-4911]).
BOX 5. Occupational exposure management resources
National
Clinicians' Postexposure Prophylaxis Hotline (PEPline)
Run by University of California‚ San Francisco/San Francisco
General Hospital staff; supported by the Health Resources
and Services Administration Ryan White CARE Act, HIV/AIDS
Bureau, AIDS Education and Training Centers, and CDC. |
Phone:
(888) 448-4911
Internet:
http://www.ucsf.edu/hivcntr
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Needlestick!
A website to help clinicians manage and document occupa-tional
blood and body fluid exposures. Developed and maintained
by the University of California, Los Angeles (UCLA), Emergency
Medicine Center, UCLA School of Medicine, and funded in
party by CDC and the Agency for Healthcare Research and
Quality. |
Internet:
http://
www.needlestick.mednet.ucla.edu |
| Hepatitis
Hotline. |
Phone:
(888) 443-7232
Internet:
http://www.cdc.gov/hepatitis
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| Reporting
to CDC: Occupationally acquired HIV infections and
failures of PEP. |
Phone:
(800) 893-0485 |
| HIV
Antiretroviral Pregnancy Registry. |
Phone:(800)
258-4263
Fax:
(800) 800-1052
Address:
1410
Commonwealth Drive
Suite 215
Wilmington, NC 28405
Internet:
http://www.glaxowellcome.com/
preg_reg/antiretroviral
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Food
and Drug Administration
Report unusual or severe toxicity to antiretroviral agents.
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Phone:
(800) 332-1088
Address:
MedWatch
HF-2, FDA
5600 Fishers Lane
Rockville, MD 20857
Internet:
http://www.fda.gov/medwatch
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| HIV/AIDS
Treatment Information Service. |
Internet:
http://www.hivatis.org |
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