Guidelines for post exposure prophylaxis pep for hiv. Was the needle from a ward with known hiv positive patients. Postexposure prophylaxis is the practice of providing treatment immediately after a suspected or confirmed biological agent release in order to attempt to limit the duration, severity, incidence and transmission of subsequent disease in asymptomatic individuals. Needlestick injury and postexposure prophylaxis cancer. Hepatitis post exposure prophylaxis if pep is indicated, it should ideally be initiated within one hour and not later than 72 hours after the exposure. Irrigate eyes with clean water, saline, or sterile irrigants. Recommendations on the management and postexposure. The hours of operation for occupation pep consultation are 11 a. Assess the patients readiness and ability to cooperate to allow the injection.
It involves taking hiv medications as soon as possible after a potential exposure to hiv. Post exposure prophylaxis to occupational injuries for general dentist. Uk seroprevalence data for bloodborne infections in people who use. After a needle stick injury, healthcare professionals are also at risk for acquiring hepatitis c. If the patient is known to have undetectable hiv viral load jun 26, 2019 pep, or postexposure prophylaxis, is a short course of hiv medicines taken very soon after a possible exposure to hiv to prevent the virus from taking hold in your body. Guideline for management of occupational exposure to blood and. Referphysicianto posttest counselling see annex io. Cdc pdf recommendations on postexposure prophylaxis for healthcare workers potentially exposed to hiv. Pep quick guide for occupational exposures updated. Post exposure prophylaxis to occupational injuries for.
It is extremely unlikely that this will change, as randomised studies of different drug regimens for pep are not feasible owing to the complexity of exposure, low event rate. American nurses associations needlestick prevention guide. Post exposure prophylaxis an overview sciencedirect topics. Postexposure prophylaxis pep catie canadas source for. Post exposure prophylaxis for hiv, hbv and hcv vii integrated protocol for managing exposures to blood and body fluids in manitoba. Guideline for management of occupational exposure to blood. Needlestick and other sharps injuries a percutaneous piercing wound. Post exposure needlestick policy office of risk management. Postexposure prophylaxis pep means taking hiv medicines very soon after a possible exposure to hiv to prevent becoming infected with hiv. Knowledge regarding postexposure prophylaxis of hiv among. Most exposure incidents and needlestick injuries can be prevented by taking the appropriate precautions. Exposures to hbv, hcv, and hiv and recommendations for. This information is presented at the hicc meeting and preventive actions to avoid needlestick injuries, if any, are recorded. Postexposure prophylaxis pep hiv risk and prevention.
It is extremely unlikely that this will change, as randomised studies of different drug regimens for pep are not feasible owing to the complexity of exposure, low event rate, and inability to ethically have a placebo group. Pathogens standard and cdcs universal precautions12 postexposure prophylaxis. If the source patients hiv serology is subsequently found to be negative and has no symptoms of acute infection, postexposure prophylaxis can be discontinued and no further follow up for hiv testing is necessary. Request pdf postexposure prophylaxis the mean risk of acquiring hiv after an occupational exposure, injecting drug use or sexual exposure varies from pep toolkit report of the scientific advisory committee of the health protection surveillance. Post exposure prophylaxis pep post exposure prophylaxis is generally means the medical response given to prevent the transmission of bloodborne pathogens following a potential exposure to hiv, hbsag, hcv and other virus. Request that the patient remain calm and avoid sudden movements. Whoilo joint guidelines on health services and hivaids, 2005 pdf, 420kb.
Post hiv exposure management prophylaxis pep occupational exposure. Pep must be started as soon as possible to be effectiveand always within 72 hours. Bloodborne infectious diseases emergency needlestick. Guidelines for the management of occupational exposures to hbv. Expert consultation for health care professionals can obtained by calling the national clinician consultation centers postexposure prophylaxis pepline at 8884484911. Pep, or postexposure prophylaxis, is a short course of hiv medicines taken very soon after a possible exposure to hiv to prevent the virus from taking hold in your body. Needle stick injuries in the community pubmed central pmc.
Several months later, she learned she also was infected with hepatitis c. Post exposure prophylaxis, or pep, is a way to help prevent the transmission of hiv in an hivnegative person who may have been recently exposed to the virus. Cdc bloodborne infectious diseases emergency needlestick. The amount of virus in the patients blood at time of exposure immune status of worker severity of the needle stick appropriate post exposure prophylaxis hiv needle stick 0. The flowcharts, as well as tables on hiv risk assessment and hbv management, are. Hbv is the most stable of the bloodborne viruses and can be transmitted by a minute amount of blood. The questionnaire was translated into bahasa malaysia and the questionnaires were. For higher risk exposures injury is deep or involves a hollow needle or the source is more infectious e.
Nov 17, 2011 a blood or body fluid exposure that occurs as a consequence of a workrelated activity there are two types of blood and body fluid exposure. Post exposure prophylaxis, occupational exposure 1. Only the highest risk needlestick injuries are offered hiv post exposure prophylaxis which consists of 23 antiretroviral medications administered for 28 days. Pep must be started within 72 hours 3 days after a possible exposure to hiv. A highrisk or severe injury, according to the us phsg, and as we defined it in our study, is an exposure to. Post exposure prophylaxis, occupational exposure 16,953 views. If the patient is known to have undetectable hiv viral load pdf version is hyperlinked for ease in navigating around the document. Knowledge regarding postexposure prophylaxis of hiv among nurses. Post exposure prophylaxis pep naco guidelines post.
And recommendations for post exposure prophylaxis pep. A needlestick injury is the penetration of the skin by a hypodermic needle or other sharp object that has been in contact with blood, tissue or other body fluids before the exposure. Post exposure prophylaxis pep means taking hiv medicines very soon after a possible exposure to hiv to prevent becoming infected with hiv. Percutaneous exposure to potentially infectious body fluid e.
Visit the prescribe hiv prevention website to learn about using prep and pep to reduce new hiv infections. Postexposure prophylaxis with antiretroviral medications can reduce the risk of hiv trans. Pathak r, kahlon as, ahluwalia sk, sharma s, bhardwaj r. Postexposure prophylaxis pep understanding hivaids. If you experienced a needlestick or sharps injury or were exposed to the blood or other body fluid of a patient during the course of your work, immediately follow these steps. Pep 101 consumer info sheet english and spanish pdf icon pdf 691 kb resources for providers. Request pdf postexposure prophylaxis the mean risk of acquiring hiv after an occupational exposure, injecting drug use or sexual exposure varies from post exposure prophylaxis, or pep, is a method of preventing hiv infection. No post exposure prophylaxis is available for hepatitis c. Eight months later, she began to feel ill, and nine months and nine days after her injury, she was diagnosed with hiv. Visit the nonoccupational postexposure prophylaxis npep toolkit from the aetc national coordinating resource center external icon.
Adherence to standard infection control practices is the best way to prevent bloodborne infections in the health care setting. Consultation can be obtained from occupational health or employee health services, local experts, or the cccs pepline. It involves using a fourweek course of the drugs used to treat hiv, taken very soon after a person may have been exposed to the virus. Needle stick injury nsi non occupational exposure sexual exposure to a source who may be infected with a blood borne virus such as human immunodeficiency virus hiv, hepatitis b virus hbv and hepatitis c virus hcv. This information is presented at the hicc meeting and preventive actions to avoid needle stick injuries, if any, are recorded. Hiv post exposure prophylaxis drug regimens treatment should be initiated within hours of exposure, ideally within 72 hours.
Apr 11, 2015 the guidelines concerning the viral load of the source patient have recently changed. Recommendations on the management and postexposure prophylaxis of needlestick injury or mucosal contact to hbv, hcv and hiv background since publication in 2007 of this set of local guidelineon s. Hiv assessment and post exposure prophylaxis pep has a significant injury occurred. It is an emergency measure, rather than one to be used as a regular method of preventing hiv transmission. If you experienced a needlestick or sharps injury or were exposed to the blood or other body fluid of a patient during the course of your work. Postexposure prophylaxis after nonoccupational and occupational exposure to hiv. The prevalence of accidental needle stick injury and their.
Preventing needlestick injuries among healthcare workers pdf, 576kb. Preventing needlestick injuries among healthcare workers. It is not meant for regular use by people who may be exposed to hiv frequently. The aim is to ensure that appropriate assessment has been made and timely treatment initiated where appropriate.
Pep is the use of antiretroviral drugs after a single highrisk event to stop hiv seroconversion. May 10, 2019 post exposure prophylaxis pep means taking hiv medicines very soon after a possible exposure to hiv to prevent becoming infected with hiv. In occupational needle stick exposures, zidovudine prophylaxis was shown to reduce the risk of hiv transmission from a positive source by 80%. Prophylaxis of needlestick injury or mucosal contact to hbv, hcv and hiv background occupational exposure to bloodborne pathogens is a wellrecognised hazard to health care workers hcw.
Interim statement regarding potential fetal harm from exposure to dolutegravir implications for hiv postexposure prophylaxis pep. Adherence to standard infection control practices is the best way. The risk of acquiring hbv from an occupational needle stick injury when the source is hepatitis b surface antigen hbsagpositive ranges from 2% to 40%, depending on the sources level of viremia. Anyone who thinks they may have been exposed to hiv should contact their doctor, a hospital. Postexposure prophylaxis an overview sciencedirect topics. It should be initiated as soon as possible, within hours and no later than 72 h following the potential exposure.
Pathogen involved the type of exposure the amount of virus in the patients blood at time of exposure immune status of worker severity of the needle stick appropriate post exposure prophylaxis hiv needle stick 0. Exposure which may place an hcpat risk ofbloodborne infection is defined as. Recommendations on the postexposure management and. Even though the acute physiological effects of a needlestick injury are generally negligible, these injuries can lead to transmission of bloodborne diseases, placing those exposed at increased risk of infection. If you experienced a needlestick or sharps injury or were exposed to the. Referral should be either a narrative letter or the pep proforma in appendix 1 only. Hivdraw testbloodat 3 expla in post exposure exposure andto inclu6 monthsde ri nse the. Needlestick or sharps injuries occur when a needle or other sharp instrument. For the following scenarios featuring risk factors for blood borne virus transmission from a needlestick, discuss with a senior clinician and consider referral to the infectious diseases fellow during hours or oncall consultant after hours. Postexposure prophylaxis pep guidelines for children. Followup and statistics of needle stick injury are done by the hic nurse on a weekly basis. Complete body fluid exposure forms as for needle stick injury. At risk health care personnel are at risk of bloodborne infection transmission through exposure of a percutaneous injury e.
Post exposure prophylaxis is the practice of providing treatment immediately after a suspected or confirmed biological agent release in order to attempt to limit the duration, severity, incidence and transmission of subsequent disease in asymptomatic individuals. Scope this guideline provides information for all queensland public health system employees permanent. This will lower the number of organisms below that required to initiate infection. Flush splashes to the nose, mouth, or skin with water. Post exposure prophylaxis and prophylactic treatment for. This policy provides guidelines for the risk assessment and subsequent management of occupational and nonoccupational exposures to hiv and the use of postexposure prophylaxis. The guidelines concerning the viral load of the source patient have recently changed. Pep quick guide for occupational exposures clinician. Prophylaxis of needlestick injury or mucosal contact to hbv, hcv and hiv. Hcwhcp exposure nsihcwhcp exposure nsi an exposure that might place hcp at risk for hbv, hcv, or hiv infection a percutaneous injury e.
July 1, 2019 these ccc postexposure prophylaxis pep recommendations will help you with urgent decisionmaking for occupational exposures to hiv and hepatitis b and c. Postexposure prophylaxis, or pep, is a way to help prevent the transmission of hiv in an hivnegative person who may have been recently exposed to the virus. For these scenarios, consult with the infectious diseases fellow during hours or consultant through switchboard after. Core concepts occupational postexposure prophylaxis. Apr 07, 2020 6,7,8,9,10,11,12, hepatitis b vaccination and adherence to recommended post exposure practices are strategies that can influence the outcome and impact of needlestick injury. Unfortunately the exact number of healthcare workers who have developed hepatitis c after a needle stick injury remains unknown, because of lack of follow up. Postexposure prophylaxis for hiv, hbv and hcv 1 integrated protocol for managing exposures to blood and body fluids in manitoba quick pep guide figure 1 diagram of initial, nonspecific portion of the pep algorithm p e p a l g a o r i t h m v i n i t i a l n o n s p e c i f go to e of i c initiate nonspecific prophylaxis sec. Procedure to follow after a needlestick or sharps injury. Needle stick injury and inadequate post exposure practices among health care workers of a tertiary care centre in rural india. A 28day course of a combination of three antiretroviral drugs. Followup and statistics of needlestick injury are done by the hic nurse on a weekly basis.
Today, she is an active member of her state nurses association. Recommendations for the management of occupational. You must start it within 72 hours after you were exposed to hiv, or it wont work. Knowledge, attitude and practices of hiv post exposure prophylaxis amongst health workers in lagos university teaching hospital. Contact with the mucous membranes of the eye or mouth. Postexposure prophylaxis pep guidelines for children and adolescents potentially exposed to. Policy checklist for bloodborne exposure control pdf, 18kb. Postexposure prophylaxis after nonoccupational and occupational exposure to.
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