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CDC Prevention Guidelines
Table 1:
Increased risk
No increased risk
Recommended
Offer
ZDV plus 3TC, ± IDV**
ZDV plus 3TC
Source: The Centers for Disease Control and Prevention
Provisional Public Health Service recommendations for chemoprophylaxis
after occupational exposure to HIV, by type of exposure and source material -- 1996
Type of Exposure
Source Material*
Antiretroviral Prophylaxis+
Antiretroviral Regimen&
Percutaneous
Blood£
Highest risk
Recommended
ZDV plus 3TC plus IDV
Fluid containing visible blood,
other potentially infectious fluid++,
or tissue
Offer
ZDV plus 3TC
Other body fluid
(e.g., urine)
Not Offer
Mucous Membrane
Blood
Offer
ZDV plus 3TC, ± IDV**
Fluid containing visible blood,
other potentially infectious fluid++,
or tissue
Offer
ZDV, ± 3TC
Other body fluid
(e.g., urine)
Not Offer
Skin
Increased risk Blood
Offer
ZDV plus 3TC, ± IDV**
Fluid containing visible blood,
other potentially infectious fluid++,
or tissue
Offer
ZDV, ± 3TC
Other body fluid
(e.g., urine)
Not Offer
* Any exposure to concentrated HIV (e.g., in a research laboratory or production facility) is
treated as percutaneous exposure to blood with highest risk.
+ Recommend -- Postexposure prophylaxis (PEP) should be recommended to the exposed worker with counseling (see text).
Offer -- PEP should be offered to the exposed worker with counseling (see text).
Not offer -- PEP should not be offered because these are not occupational exposures to HIV (1).
& Regimens: zidovudine (ZDV), 200 mg three times a day; lamivudine (3TC), 150 mg two times a day; indinavir (IDV), 800 mg three times a day (if IDV is not available, saquinavir may be used, 600 mg three times a day). Prophylaxis is given for 4 weeks. For full prescribing information, see package inserts.
£ Highest risk -- BOTH larger volume of blood (e.g., deep injury with large diameter hollow
needle previously in source patient's vein or artery, especially involving an injection of
source-patient's blood) AND blood containing a high titer of HIV (e.g., source with acute
retroviral illness or end-stage AIDS; viral load measurement may be considered, but its use
in relation to PEP has not been evaluated).
Increased risk -- EITHER exposure to larger volume of blood OR blood with a high titer of HIV.
No increased risk -- NEITHER exposure to larger
volume of blood NOR blood with a high titer of HIV (e.g., solid suture needle injury from source patient with asymptomatic HIV infection).
** Possible toxicity of additional drug may not be warranted (see text).
++ Includes semen; vaginal secretions; cerebrospinal, synovial, pleural, peritoneal, pericardial, and amniotic fluids.
&& For skin, risk is increased for exposures involving a high titer of HIV; prolonged contact, an extensive area, or an area in which skin integrity is visibly compromised. For skin
exposures without increased risk, the risk of drug toxicity outweighs the benefit of PEP.
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