HIV stick

Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis

Summary

This report updates and consolidates all previous U.S. Public Health Service recommendations for the management of health-care personnel (HCP) who have occupational exposure to blood and other body fluids that might contain hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV).

Recommendations for HBV postexposure management include initiation of the hepatitis B vaccine series to any susceptible, unvaccinated person who sustains an occupational blood or body fluid exposure. Postexposure prophylaxis (PEP) with hepatitis B immune globulin (HBIG) and/or hepatitis B vaccine series should be considered for occupational exposures after evaluation of the hepatitis B surface antigen status of the source and the vaccination and vaccine-response status of the exposed person. Guidance is provided to clinicians and exposed HCP for selecting the appropriate HBV PEP.

Immune globulin and antiviral agents (e.g., interferon with or without ribavirin) are not recommended for PEP of hepatitis C. For HCV postexposure management, the HCV status of the source and the exposed person should be determined, and for HCP exposed to an HCV positive source, follow-up HCV testing should be performed to determine if infection develops.

Recommendations for HIV PEP include a basic 4-week regimen of two drugs (zidovudine [ZDV] and lamivudine [3TC]; 3TC and stavudine [d4T]; or didanosine [ddI] and d4T) for most HIV exposures and an expanded regimen that includes the addition of a third drug for HIV exposures that pose an increased risk for transmission. When the source person's virus is known or suspected to be resistant to one or more of the drugs considered for the PEP regimen, the selection of drugs to which the source person's virus is unlikely to be resistant is recommended.

In addition, this report outlines several special circumstances (e.g., delayed exposure report, unknown source person, pregnancy in the exposed person, resistance of the source virus to antiretroviral agents, or toxicity of the PEP regimen) when consultation with local experts and/or the National Clinicians' Post-Exposure Prophylaxis Hotline ([PEPline] 1-888-448-4911) is advised.

Occupational exposures should be considered urgent medical concerns to ensure timely postexposure management and administration of HBIG, hepatitis B vaccine, and/or HIV PEP.

full article: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm

May I recommend that you check out the website of the CDC? It's part of their job to make recommendations about this situation ... they probably have at least as good advice as anyone, and likely better, since they get all the reports of job-related hiv conversion ... around 30 years of data. From there you can look up the meds recommended and decide for yourself if you want to take them.

Remember ... there's no such thing as a drug with no side effects. It's a risk/benefit judgement call and that's between you and your doc.

But most of all, if you get stuck, don't panic. The incidence of sero-conversion after a single contaminated stick is pretty low, as I understand it. You need to take action and use reasonable precautions until you know for sure whether you've been infected, but try to relax until you know for sure.

You actually have much more to fear from the various strains of viral hepatitis, but the same advice hold true.

I think you're a smart cookie to ask the questions now, before anything happens. The more info you have going into it, the less freaked out you will be if anything actually happens.

Sniped by Jolie!!

This professor, and he is an awesome professor, pretty much had us all terrified-with our mouths hanging open and our pop eyes apoppin!

He's right to try to reinforce that you need to pay attention to this stuff.

If his goal was to get you to check it out on your own, I'd say he succeeded.

Smart dude.

Even smarter students. You go!