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Postexposure Care and Prophylaxis for Providers

Sterile. ARVs. Postexposure Care and Prophylaxis for Providers. Risk of HIV Infection after Occupational Exposure. If 300 people receive needle-stick or sharp-instrument injuries at their job sites, from an HIV-infected source, how many do you think will be infected with HIV? 1 in 300

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Postexposure Care and Prophylaxis for Providers

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  1. Sterile ARVs Postexposure Care and Prophylaxis for Providers

  2. Risk of HIV Infection after Occupational Exposure If 300 people receive needle-stick or sharp-instrument injuries at their job sites, from an HIV-infected source, how many do you think will be infected with HIV? • 1 in 300 • 10 in 300 • 100 in 300 Source: Bell, 1997.

  3. Risk of HIV Infection after Occupational Exposure If 1000 people had mucous membranes or broken skin exposed to HIV, how many do you think will be infected? • 1 in 1000 • 50 in 1000 • 100 in 1000 • 200 in 1000 Source: Bell, 1997.

  4. Risk of HIV Infection after Occupational Exposure What factors do you think might influence whether a provider becomes infected after exposure? Risk depends on: • Amount of blood on the needle/device • Depth of the injury • Whether needle or device was placed directly in patient’s artery or vein • Infectious status of source person Source: CDC, 2005.

  5. Postexposure Care:Immediately • Wash injured area with soap and water • If water is not available, use antiseptic solution to flush area • If eyes, mouth, or nose are splashed, irrigate with clean water, saline, or sterile irrigation solution • Do not apply caustic agents (e.g., bleach) Source: CDC, 2001.

  6. Postexposure Care:After Providing Immediate Care continued … • Evaluate risk of infection based on exposure: • type and amount of contaminated body fluid • type and severity of wound • infectiousness of source patient • Determine HIV status of source patient, following appropriate counseling and disclosure guidelines • Provide counseling, HIV testing, PEP treatment, and follow-up care Source: CDC, 2001 and 2005.

  7. Postexposure Care:Additional Recommendations Until status is known: • Avoid donating blood, organs, tissue, semen • Abstain from intercourse or use a condom • Comply with ARV regimen (if accepting therapy) • Obtain counseling for self and partner(s) If pregnant or breastfeeding, counsel about: • Risk of MTCT (first trimester, maximum risk) • Availability of MTCT drug therapy, side effects • Avoiding breastfeeding until status known Source: CDC, 2001 and 2005.

  8. ARV Drugs for PEP – Guidelines • Start as soon as possible • Continue for 4 weeks • Use multidrug therapy – more effective • Conduct routine toxicity tests • Report sudden or severe flu-like symptoms • Conduct antibody tests (baseline, 6 weeks, 12 weeks, and 6 months) Guidelines for managing PEP should be established. Source: CDC, 2005.

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