African
Journals On-line
Annals of African Medicine
Volume
2, Number 1, June 2003
ABSTRACTS
Management
of occupational exposure to the human immunodeficiency viruses
I. Babajide Keshinro
Department of Medicine, Ahmadu Bello University Teaching Hospital, Zaria.
Nigeria
Abstract
By the end of the year 2002, the
World Health Organisation estimated that 42 million people have been infected
with the Human Immunodeficiency Viruses (HIV). Though sexual transmission is
the commonest mode of transmission, transmission to the health care personnel
(HCP) who are exposed to blood and blood products remains an increasing risk.
Because there is no cure or effective vaccine for HIV infection, optimal
post-exposure care, including the administration of antiretroviral drugs to
prevent HIV infection, remains a high priority for protecting health care
personnel. Factors that should
be considered in the choice of treatmentfor an exposed health care worker
include the risk of HIV infectionassociated with the exposure, the
expected benefit of antiretroviraltreatment, the risks associated
with the proposed treatment,and the probability that the infecting
strains will be susceptibleto the antiretroviral regimen used. U.S.
public health guidelines recommend that a four-week regimen of two drugs
be started as soon as possible after most cases of HIV exposure through
percutaneous or mucosal routes.If the source person is found to be
HIV-negative treatment should be discontinued. When the injury involves an
increased risk of HIV transmission, the regimen should be expanded to
include a third drug. Since post-exposure prophylaxis is not 100% effective,
prevention strategies through safer practices, barrier precautions, safer
needle devices, and other innovations, remain the best way to prevent
occupational infection by HIV and other blood borne pathogens.
Key Words: HIV, occupational exposure,
post-exposure prophylaxis
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