HIV POSITIVE  Caretakers
Occupational Exposure to HIV NEW!

Approximately 4.4 million health care workers in the United States receive an estimated 800,000 needle sticks and other injuries from sharp objects annually.1

An estimated 16,000 of these objects are contaminated with HIV.2
HIV is transmitted by approximately 3 of every 1000 HIV-contaminated needle sticks.3

In spite of the widespread acceptance of universal precautions as required by the Occupational Safety and Health Administration (OSHA), the overall rate of needle-stick injuries remains high.2 The risk of HIV transmission was decreased by 79% in healthcare workers who received zidovudine after their exposure.4

Since HIV transmission was reduced by approximately 79% when health care workers with percutaneous exposure to HIV-infected blood received zidovudine,4 in June 1996 the Public Health Service issued provisional recommendations for chemoprophylaxis after exposure, depending on the type of exposure and the source. After a percutaneous exposure to blood, treatment with zidovudine plus lamivudine is recommended for four weeks. For workers whose exposures place them at the highest risk, treatment with indinavir, a protease inhibitor, should be added.5

In the case of HIV, prophylaxis should be initiated promptly, preferably within one to two hours after the exposure.5 Follow-up counseling and medical evaluation as summarized in the Public Health Service recommendations is a necessity.5

References: 1.29 CFR Part 1910.1030 (1991). 2. Jagger J, Pearson RD. Universal precautions: still missing the point on needlesticks. Infec Contro Hosp Epidemiol 1991;12:211-3. 3. Case-control study of HIV seroconversion in health-care workers after percutaneous exposure to HIV-infected blood -- France, United Kingdom, and United States, January 1988 -- August 1994. MMWR Morb Mortal Wkly Rep 1995;44:929-33. 4. Update: provisional Public Health service recommendations for chemprophylaxis after occupational exposure to HIV. MMWR Morb Mortal Wkly Rep 1996;45:468-80. 5. Recommendations for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures. MMWR Morb Mortal Wkly Rep 1991;40(RR-8):1-9.

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