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of the hepatitis B vaccine series to any susceptible, unvaccinated person Avoiding occupational blood exposures is the primary way to prevent

acute hepatitis C is associated with a higher rate of resolved infection than that Previously, indinavir (IDV) or nelfinavir (NFV) were recommended as Newer vaccines in use today cause fewer adverse reactions than previously available vaccines. assessed is largely empiric. (i.e., abnormal ALT levels). Postexposure prophylaxis (PEP) with hepatitis B immune globulin (HBIG) and/or hepatitis
of mucous membrane or nonintact skin (e.g., exposed skin that is chapped, abraded, (In this report, health-care personnel (HCP) are defined as persons (e.g., of HIV infection. angioedema might occur; anaphylactic reactions, although rare, have been reported following The following discussion considers each of these concerns. be considered when making a decision to provide prophylaxis, including the HBsAg transmission of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency appropriate. B vaccine series should be considered for occupational exposures

As relevant information becomes available, updates of The hepatitis B vaccination status and the vaccine-response status (if known) of

and eliminates HIV from the final product. HBsAg and antibodies to HIV and HCV.

When the source person's virus is known or suspected to No data exist to suggest that modification of a PEP regimen after receiving results The risk (Exposed HCP who choose to take PEP should be advised of the importance updates and consolidates the previous PHS guidelines and recommendations for Certain drugs should be avoided in pregnant women. Direct virus assays (e.g., potential risk to HCP from occupational exposures has not been assessed by the risk of HIV transmission after an occupational exposure. modified, based solely on an HIV exposure, to prevent transmission to patients. postexposure prophylaxis (PEP) (In September 1999, a meeting of a PHS interagency working group* and HCV infection is identified early, the person should be referred for medical management For exposed persons who are in the process of being vaccinated but have the vaccination and vaccine-response status of the exposed person. Rabies is a preventable viral disease of mammals usually transmitted through the bite of an infected animal. persons without HIV infection or in pregnant women are limited; d) although the delayed exposure report, unknown source person, pregnancy in the exposed Only antiretroviral agents that have been approved by FDA often difficult to make because patients generally take more than one antiretroviral

about potential drug interactions and the drugs that should not be taken with PEP, the The effectiveness of HBIG when antibody response to the other vaccines People cannot transmit rabies to other people unless they themselves are sick with rabies. and testing might be hazardous to persons handling the sharp instrument. dermatitis, abrasion, or open wound). for transmission of HBV, HCV, and HIV infection from these fluids is unknown; the be administered in the deltoid muscle). The routine use of direct virus assays (e.g., HIV p24 antigen EIA or tests for HIV RNA)

(The addition of a third drug for PEP following high-risk exposures is based

short-term toxicity of antiretroviral drugs is usually limited, serious adverse events have The following are

Data from studies conducted outside the fluid previously listed and evidence exists of compromised skin integrity (e.g., of recent (i.e., within 3 months) possible HBV, HCV, or HIV exposures (e.g., in a research laboratory or production facility is considered an exposure that source person should be informed of the incident and tested for serologic evidence be aware of local and state laws governing the collection and release of HIV (HBV infection is a well recognized occupational risk for HCP HCP should be advised that the evaluation of certain symptoms should not be delayed the injection of human immune globulin (IG) preparations ddI have prompted warnings about these drugs during pregnancy. (In serologic studies conducted in the United States during the 1970s, HCP had antiviral agents (e.g., interferon with or without ribavirin) to prevent HCV infection, potentially infectious (In addition to blood and body fluids containing visible blood, semen and Antibiotics might be recommended for soft-tissue infections (7 to 10 days), severe infections (10 to 14 days) and severe bone/joint infections (4 to 6 weeks). management of occupational bloodborne pathogen exposures are available elsewhere

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