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RISK
HBV
6-30%
HCV
0.4 - 2%
HIV
0.3%
HCV- PEP
No efective vaccine or chemo prophylactic agent for preventing
HCV infection after accidental occupational exposure.
For the source, perform testing for anti-HCV.
For the person exposed to an HCV-positive source
perform baseline testing for anti-HCV and ALT activity.
Follow Up
- Perform baseline and follow-up testing for anti-HCV and alanine
aminotransferase (ALT) 46 months after exposures.
- Perform HCV RNA at 46 weeks if earlier diagnosis of HCV
infection desired.
- Confirm repeatedly reactive anti-HCV enzyme immunoassays
(EIAs) with supplemental tests.
Data indicate that antiviral therapy might be beneficial when
HIV - PEP
HIV should be evaluated within hours (rather than days) after their
exposure and should be tested for HIV at baseline (i.e., to establish
infection status at the time of exposure).
If the source person is seronegative for HIV, baseline testing or further
follow-up of the exposed person normally is not necessary.
For HIV PEP, the evaluation also should include information about
medications the exposed person might be taking and any current or
underlying medical conditions or circumstances (i.e., pregnancy, breast
feeding, or renal or hepatic disease) that might influence drug selection.
Most occupational HIV exposures do not result in the transmission of
HIV, potential toxicity must be carefully considered when prescribing
PEP.
Follow Up
Perform HIV-antibody testing for at least 6 months
postexposure (e.g., at baseline, 6 weeks, 3 months, and 6
months).
Perform HIV antibody testing if illness compatible with
an acute retroviral syndrome occurs.
Advise exposed persons to use precautions to prevent
secondary transmission during the follow-up period.
Evaluate exposed persons taking PEP within 72 hours
after exposure and monitor for drug toxicity for at least 2
weeks
BASIC REGIMEN
Zidovudine (RETROVIR; ZDV; AZT) + Lamivudine (EPIVIR;
3TC); available as COMBIVIR
ZDV: 600 mg per day, in two or three divided doses.
3TC: 150 mg twice daily.
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