Management of occupational exposure to the human immunodeficiency viruses

Abstract

By the end of the year 2002, the World Health Organisation estimated that 42 million people have been infected with the Human Immunodeficiency Viruses (HIV). Though sexual transmission is the commonest mode of transmission, transmission to the health care personnel (HCP) who are exposed to blood and blood products remains an increasing risk. Because there is no cure or effective vaccine for HIV infection, optimal post-exposure care, including the administration of antiretroviral drugs to prevent HIV infection, remains a high priority for protecting health care personnel. Factors that should be considered in the choice of treatmentfor an exposed health care worker include the risk of HIV infectionassociated with the exposure, the expected benefit of antiretroviraltreatment, the risks associated with the proposed treatment,and the probability that the infecting strains will be susceptibleto the antiretroviral regimen used. U.S. public health guidelines recommend that a four-week regimen of two drugs be started as soon as possible after most cases of HIV exposure through percutaneous or mucosal routes.If the source person is found to be HIV-negative treatment should be discontinued. When the injury involves an increased risk of HIV transmission, the regimen should be expanded to include a third drug. Since post-exposure prophylaxis is not 100% effective, prevention strategies through safer practices, barrier precautions, safer needle devices, and other innovations, remain the best way to prevent occupational infection by HIV and other blood borne pathogens.


Keywords: HIV, occupational exposure, post-exposure prophylaxis


Annals of African Medicine Vol.2(1) 2003: 1-5