Updated U.S. Public Health Service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis
Published Date:June 29, 2001
Source:MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 2001; 50(RR-11):1-52.
Corporate Authors:Centers for Diseases Control and Prevention (U.S.) ; National Center for HIV, STD, and TB Prevention (U.S.) ; National Center for Infectious Diseases (U.S.) ; ... More ▼
Hepatitis B Vaccines
Hepatitis B Virus
Infectious Disease Transmission, Patient-to-Professional
Prevention & Control
Anti-HIV Agents/Therapeutic Use
Hepatitis B/Prevention & Control/United States
Hepatitis B/Transmission/United States
Hepatitis B Virus/Immunology
Hepatitis C/Transmission/United States
HIV Infections/Prevention & Control/United States
HIV Infections/Transmission/United States
Infectious Disease Transmission, Patient-to-Professional/Prevention & Control
Occupational Exposure/Prevention & Control/United States
Series:MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports ; v. 50, no. RR-11
Description:Summary -- Introduction -- Background -- Recommendations for the management of hcp potentially exposed to HBV, HCV, or HIV -- References -- Appendix A. Practice recommendations for health-care facilities implementing the U.S. Public Health Service guidelines for management of occupational exposures to bloodborne pathogens -- Appendix B. Management of occupational blood exposures.
This report updates and consolidates all previous U.S. Public Health Service recommendations for the management of health-care personnel (HCP) who have occupational exposure to blood and other body fluids that might contain hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV). Recommendations for HBV postexposure management include initiation of the hepatitis B vaccine series to any susceptible, unvaccinated person who sustains an occupational blood or body fluid exposure. Postexposure prophylaxis (PEP) with hepatitis B immune globulin (HBIG) and/or hepatitis B vaccine series should be considered for occupational exposures after evaluation of the hepatitis B surface antigen status of the source and the vaccination and vaccine-response status of the exposed person. Guidance is provided to clinicians and exposed HCP for selecting the appropriate HBV PEP. Immune globulin and antiviral agents (e.g., interferon with or without ribavirin) are not recommended for PEP of hepatitis C. For HCV postexposure management, the HCV status of the source and the exposed person should be determined, and for HCP exposed to an HCV positive source, follow-up HCV testing should be performed to determine if infection develops. Recommendations for HIV PEP include a basic 4-week regimen of two drugs (zidovudine [ZDV] and lamivudine [3TC]; 3TC and stavudine [d4T]; or didanosine [ddI] and d4T) for most HIV exposures and an expanded regimen that includes the addition of a third drug for HIV exposures that pose an increased risk for transmission. When the source person's virus is known or suspected to be resistant to one or more of the drugs considered for the PEP regimen, the selection of drugs to which the source person's virus is unlikely to be resistant is recommended. In addition, this report outlines several special circumstances (e.g., delayed exposure report, unknown source person, pregnancy in the exposed person, resistance of the source virus to antiretroviral agents, or toxicity of the PEP regimen) when consultation with local experts and/or the National Clinicians' Post-Exposure Prophylaxis Hotline ([PEPline] 1-888-448-4911) is advised. Occupational exposures should be considered urgent medical concerns to ensure timely postexposure management and administration of HBIG, hepatitis B vaccine, and/or HIV PEP.
Supporting Files:No Additional Files
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