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Management of healthcare personnel exposed to HIV

Authors
John G Bartlett, MD
David J Weber, MD, MPH
Section Editor
Martin S Hirsch, MD
Deputy Editor
Jennifer Mitty, MD, MPH

INTRODUCTION

The potentially grave consequences of exposure to body fluids from people infected with HIV have prompted development of policies and procedures designed to reduce the risk in healthcare personnel (HCP). The most important practice is the use of available measures to prevent such exposures. Although the incidence of needlestick injuries has been reduced by advances in education, needle disposal, engineering changes (eg, needleless devices, safety needles) and personnel protection, institutions and healthcare professionals must continue to assume responsibility in further lowering the risk.

The procedures to follow after HCP have had significant contact with body fluids from a patient infected with HIV are reviewed here. The epidemiology of bloodborne exposures in HCP, the Occupational Safety and Health Administration (OSHA) requirements regarding infection control procedures and training in the United States, and the management of potential exposure to other bloodborne pathogens including hepatitis B and hepatitis C virus are also discussed elsewhere. (See "Prevention of hepatitis B virus and hepatitis C virus infection among healthcare providers".)

The management and risks associated with nonoccupational exposure to HIV are discussed separately. (See "Management of nonoccupational exposures to HIV and hepatitis B and C in adults".)

Issues related to the risk of transmission of HIV from infected HCP are discussed in detail elsewhere. (See "Surgical issues in HIV infection".)

RISK OF TRANSMISSION OF HIV

The risk of transmission of HIV infection following inadvertent exposure varies widely depending upon the type of exposure. The risk is increased when the source has a high viral load, the volume is large, and the exposure is deep. The healthcare personnel (HCP) at highest risk are those who have percutaneously been inoculated with blood from an HIV-infected source. All known seroconversions have occurred with exposure to blood, bloody fluids, or viral cultures.

                               

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Literature review current through: Nov 2016. | This topic last updated: Wed May 20 00:00:00 GMT+00:00 2015.
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