Although avoiding exposure to HIV is the only reliable way of preventing HIV infection, post-exposure prophylaxis (PEP) can decrease the risk of infection after exposure to HIV. The following are key healthcare provider resources from the Federal government on PEP for both occupational exposure and non-occupational exposure (nPEP).
Exposure to blood-borne pathogens can present serious risks to health care providers. Prompt post-exposure treatment for HIV and hepatitis B virus can be effective, but because each exposure case is unique, determining who should receive prophylaxis and which drugs are most appropriate is not always easy. Key guidelines and resources from the Federal government include:
- Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis – This CDC report updates and consolidates all previous U.S. Public Health Service recommendations for the management of health-care personnel 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). [Source: CDC]
- Health-Care Worker Exposure Guidelines [Source: NIH – AIDSinfo]
- National Clinicians' Post-Exposure Prophylaxis Hotline
The PEPline provides expert guidance in managing healthcare worker exposures to HIV and hepatitis B and C. Callers receive immediate post-exposure prophylaxis recommendations. Available 9 a.m. to 2 a.m. EST every day. For urgent help, call the PEPline or access: PEPline Guidance: A quick guide to assist in urgent decision-making for occupational exposures.
- National HIV/AIDS Clinicians' Consultation Center – This clinical resource for healthcare professionals, operated by the University of California, San Francisco and San Francisco General Hospital, is part of the AIDS Education and Training Centers (AETCs), funded by the Ryan White HIV/AIDS Program of the Health Resources and Services Administration (HRSA) in partnership with the Centers for Disease Control and Prevention (CDC). The NCCC website offers clinicians:
- Current PEP guidelines and select protocols
- PEP Resources
- Access to other AIDS Education and Training Center resources for healthcare providers
Non-occupational Post-Exposure Prophylaxis (nPEP)
Non-occupational exposure is any direct mucosal, percutaneous, or intravenous contact with potentially infectious body fluids that occurs outside perinatal or occupational situations (e.g., sexual contact; sharing of injection drug needles or other equipment). Antiretroviral (ARV) therapy is an important prophylactic intervention for appropriate persons with nonoccupational exposures. Key guidelines and resources from the Federal government include:
- Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV In the United States [PDF HTML] – The U.S. Department of Health and Human Services (DHHS) Working Group on Nonoccupational Postexposure Prophylaxis (nPEP) made the following recommendations for the United States: For persons seeking care <72 hours after nonoccupational exposure to blood, genital secretions, or other potentially infectious body fluids of a person known to be HIV infected, when that exposure represents a substantial risk for transmission, a 28-day course of highly active antiretroviral therapy (HAART) is recommended. [Source: CDC]
- Nonoccupational Exposure Considerations [Source: NIH – AIDSinfo]
- Nonoccupational Postexposure Prophylaxis – chapter in Guide for HIV/AIDS Clinical Care, a manual developed to provide HIV/AIDS clinicians with ready access to practical, current, treatment information so that they may provide quality care to people living with HIV. Written and edited by expert clinicians who are part of the Ryan White HIV/AIDS Program (RWP) system, this document reflects the broad clinical expertise within the RWP. [Source: HRSA-HIV/AIDS Bureau]
- nPEP Steps: Guide to Non-Occupational Exposure – A quick guide for health care personnel developed in consultation with the National Clinician's Postexposure Prophylaxis (PEP) Hotline. Based on most current U.S. Public Health Service guidelines for non-occupational exposure. [Source: The Mountain-Plains AIDS Education and Training Center, supported by a grant from HRSA]