COMMENTARY

HIV Prophylaxis Following Occupational Exposure: Guideline and Commentary

Barry S. Zingman, MD

Disclosures

January 30, 2013

In This Article

Baseline Testing for the Exposed Worker

Recommendations:

Confidential baseline HIV testing of the exposed worker should be obtained at the time the occupational exposure is reported or within 3 days of the exposure. (AIII) Testing must be performed in full compliance with New York State Public Health Law.

PEP should be started without waiting for the results of the HIV test. (AII)

Exposed workers should be counseled that it is in their best interest to receive a baseline HIV test to document their HIV status at the time of the exposure. In the rare event of seroconversion following an occupational exposure, a negative baseline test is the only way to show that the worker was infected as a result of the exposure.

Key Point
A negative HIV test only demonstrates that the exposed worker was not previously infected with HIV before the exposure occurred; the baseline HIV test cannot determine whether the exposed worker was infected as a result of the exposure.

Baseline HIV testing of the exposed worker is also used to identify individuals who were already infected with HIV at the time of the exposure. This allows decisions to be made regarding the continuation of ART (see Antiretroviral Therapy, Section III: Deciding When to Initiate ART). However, the PEP regimen should not be discontinued until the positive result is repeated with a confirmatory assay.

PEP should be initiated without waiting for the results of the HIV test.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....