What immediate measures should be taken?• Lightly wash needlestick/cut exposed area with soap and water• Flush splashes to the nose, mouth, or skin with water• Irrigate eyes with clean water, saline, or sterile irrigants
What is considered to be a potential exposure to HIV, HBV or HCV?For transmission of blood borne pathogens (HIV, HBV and HCV) to occur, an exposure must include both of the following:• Infectious body fluid: Blood, semen, vaginal fluid, amniotic fluid, breast milk, cerebrospinal fluid, pericardial fluid, peritoneal fluid, pleural fluid and synovial fluid can transmit HIV, HBV and HCV.
Bạn đang xem: National Clinician Consultation Center
Xem thêm : How To Use Plums To Get Glowing Skin
• Note that saliva, vomitus, urine, feces, sweat, tears and respiratory secretions do not transmit HIV (unless visibly bloody). The risks of HBV and HCV transmission from non-bloody saliva are considered to be negligible.
The PEPline does not recommend routine HIV, HBV or HCV surveillance testing following exposure or possible exposure to non-bloody saliva.*
* Federal guidelines consistently emphasize that non-bloody saliva does not carry risk for transmitting HIV, stating that non-bloody saliva is not considered infectious for HIV. The federal guidelines on HBV and HCV are not as clear. They emphasize that certain non-bloody fluids, including saliva, are unlikely to transmit those viruses (various terms are used in the different guidelines), but do not make specific recommendations regarding follow-up testing. In the absence of clear federal guidelines on follow-up HBV and HCV testing following non-bloody saliva exposures, the PEPline recommendation, above, has taken many factors into consideration. Advantages of follow-up testing include: (1) reassurance for exposed persons who need additional confirmation; (2) documentation of the lack of transmission to confer liability protection; and (3) conformity with local regulations (e.g., state, hospital, or practice protocols/guidelines). Disadvantages of follow-up testing include: (1) increasing confusion and stress from the contradictory messages that the exposure does not confer transmission risk yet months of follow-up testing is to be performed; (2) addressing potential false positive test results, which create personal distress and additional healthcare costs; (3) possibly increasing work-related stress and stress-related health conditions; (4) creating a period of modified sexual practices/interactions and family planning in certain instances; and (5) increasing overall healthcare costs and time away from work. Because the transmission risk of HBV and HCV in exposures to non-bloody saliva, if any, is considered to be negligible and the disadvantages listed above are important, the PEPline does not routinely recommend follow-up testing, but does not take the position that such testing should not occur.
Xem thêm : How Long Should You Take Sermorelin?
• A portal of entry (percutaneous, mucous membrane, cutaneous with non-intact skin)If both of these factors are not present, there is no risk of blood borne pathogen transmission and further evaluation is not required.
What baseline testing should be performed after an exposure?Source Person (SP):• HIV Ag/Ab or HIV Ab (rapid HIV testing preferred if accessible)*• HCV Ab or HCV RNA (“HCV viral load”)• Testing for HBsAg (HBV surface antigen) alone is sufficient to inform management of exposed HCP. If possible, consider comprehensive HBV screening of source persons to help facilitate increased HBV screening in general. * If SP’s rapid HIV test is positive, assume this is a true positive for purposes of initial PEP decision-making, and send confirmatory/supplemental testing.Exposed Person (EP): If no blood borne pathogen exposure occurred, or SP is confirmed negative on baseline testing, no baseline testing is clinically indicated for the EP. Testing can be considered for other purposes, including medicolegal concerns or as per institutional protocols. For bites, see “How should a human bite be managed?”• HIV Ag/Ab or HIV Ab• HCV Ab (if positive, follow-up with HCV RNA testing)• HBV testing: Depends on immunization status.Note that most healthcare and public safety personnel have been vaccinated against hepatitis B. If previously vaccinated and they know they responded to the vaccine series (a positive titer after completion of either a 2- or 3-dose vaccine series is ≥ 10mIU/mL), they are considered to have lifelong immunity and require no further testing or treatment. Similarly, if employee health records indicate they responded to the vaccination series, they are considered immune. For all others, see the “Exposures to HBV” section of this guide.
Is a rapid HIV test accurate enough to decide on whether to give PEP?Rapid HIV tests are generally very sensitive and specific and can be used to determine whether to offer PEP. A positive rapid HIV test should be preliminarily considered a true positive for the purposes of initial PEP decision-making. A negative rapid test should be considered a true negative. Investigation of whether a source might be in the “window period” is unnecessary for determining whether HIV PEP is indicated unless acute HIV (acute retroviral syndrome) is clinically suspected.
Nguồn: https://buycookiesonline.eu
Danh mục: Info
