Accidental inoculation

An occupational exposure to HIV that occurs during the performance of job duties by a nurse or doctor, or other medical staff.

How does it happen?

Includes a needlestick or cut with a sharp object, contact of mucous membranes (mouth, eyes), or contact of skin (especially when the exposed skin is chapped, abraded, or afflicted with dermatitis--skin rash or sores--or the contact is prolonged or involves an extensive area) with blood, tissues, or other body fluids (stool, urine, vaginal secretions, saliva, mucous) to which universal precautions apply.

Diagnosis

History, physical examination and serological testing for HIV

Treatment

Post Exposure prophylaxis, or PEP. is the use of antiretroviral drugs after a single high-risk event to stop HIV seroconversion. PEP must be started as soon as possible to be effective—and always within 72 hours of a possible exposure.

CDC recommendations for PEP

Post Exposure Prophylaxis should start ideally within one hour as after 72 hours post-exposure PEP is much less effective,

Duration of PEP

Prophylactic treatment for HIV typically lasts four weeks.

Antibody testing

People who received PEP are typically advised to get an antibody test at 6 months post-exposure as well as the standard 3 month test.

Regimen used for PEP

• The antiretroviral regimen used in PEP is the same as the standard highly active antiretroviral therapy used to treat AIDS.
• People initiating PEP treatment typically receive a 28-day starter pack, as opposed to a 3-7 day starter pack, to facilitate strong medication adherence.
• They should also be counseled on the unpleasant side effects including malaise, fatigue, diarrhea, headache, nausea and vomiting.

PreEP

• People at high risk for re-exposure due to unprotected intercourse or other behavioral factors should be given PrEP, which would begin immediately after the completion of the nPEP treatment course.
• Inversely, if a medically-adherent patient is already on PrEP upon non-occupational exposure, nPEP treatment is not necessary.

External links

See the detailed article on PEP

Prevention

Taking adequate precautions is key.

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