2025 US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Post-exposure Prophylaxis in Healthcare Settings

Details

• Journal Article:
  Infection Control & Hospital Epidemiology
• Personal Author:
  Kofman, Aaron D. ; Struble, Kimberly A. ; Heneine, Walid ; Gayle, Britt ; de Perio, Marie A. ; Okasako-Schmucker, Devon L. ; So, Christine N. ; Anderson, Laura E. ; Stone, Erin C. ; Henderson, David K. ; Kuhar, David T.
• Description:
  Abstract: These guidelines update the 2013 “Updated US Public Health Service (PHS) Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis,” hereafter referred to as the 2013 PHS Guidelines.1,2 The availability of new medication options, new information on the window of detection for different human immunodeficiency virus (HIV) tests, and the risk of transmission from people with undetectable viral loads prompted this update. The primary intended audience for these recommendations remains anyone involved in the provision of HIV post-exposure management to healthcare personnel (HCP).
  
  The U.S. Centers for Disease Control and Prevention assembled a working group of representatives from federal agencies in the U.S. Department of Health and Human Services (HHS) who identified the priority topics for update and conducted systematic literature reviews to formulate recommendations (see Appendix). All recommendations were reviewed by the Healthcare Infection Control Practices Advisory Committee (HICPAC) at public meetings, and by a non-consensus forming panel of external experts. New evidence-based recommendations are developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and classified according to the HICPAC recommendation scheme when evidence supported recommendation development.3,4 Other recommendations in this document are classified as good practice statements according to the criteria set forth by GRADE.5 The working group solicited additional feedback on recommendations from relevant agencies, subject-matter experts, and the public.
  
  Recommendations that have changed since the 2013 PHS guidelines include: new antiretroviral drug regimens for post-exposure prophylaxis (PEP); a shortened duration of post-exposure follow-up HIV testing; elimination of routine laboratory tests for antiretroviral drug toxicity; and, considerations for PEP for HCP with exposures to source patients with undetectable viral loads.
  
  Important strategies in the principles of exposure management remain: primary prevention strategies; the prompt reporting and management of occupational exposures; adherence to recommended HIV PEP regimens when indicated; the role of expert consultation in management of exposures; and follow-up of exposed HCP.
  
  The record also serves as the landing page for the Required Web Postings related to this resource. The Required Web Posting can be located in Supporting Files section of this record. The Required Web Postings include the following: 1) Peer Review Plan: The Office of Management and Budget (OMB) Peer Review Plan for the 2025 US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis in Healthcare Settings; and, 2) Response to Peer Review of the Draft: The Office of Management and Budget (OMB) Peer Reviewer Comments and the Centers for Disease Control and Prevention (CDC) Responses for the 2025 US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis in Healthcare Settings
  
  For more information on the CDC/ATSDR Peer Review Agenda, see https://www.cdc.gov/science-quality/php/information-quality-support/cdc-atsdr-peer-review-agenda.html
  
  
• Subjects:
  Anti-HIV Agents Anti-HIV Agents / Adverse Effects Anti-HIV Agents / Therapeutic Use Emergency Medicine Guideline Health Personnel HIV HIV Infections Occupational Diseases Occupational Exposure Occupational Health Post-Exposure Prophylaxis Post-Exposure Prophylaxis / Standards Pregnancy Risk Factors

  More +
• Keywords:
  Human Immunodeficiency Virus OPeP
• DOI:
  https://doi.org/10.1017/ice.2025.10254
• ISSN:
  1559-6834 (Online) ; 0899-823X (Print)
• Publisher:
  Cambridge University Press
• Document Type:
  Text
• Genre:
  Review
• Place as Subject:
  United States
• License:
  https://creativecommons.org/licenses/by/4.0/
• Rights:
  Public Domain
• CIO:
  National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
• Division:
  DHQP - Division of Healthcare Quality Promotion
• Topic:
  Diseases & Conditions
• Location:
  North America
• Pages in Document:
  11 pdf pages
• NIOSHTIC Number:
  nn:na
• Citation:
  Kofman AD, Struble KA, Heneine W, et al. 2025 US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Post-exposure Prophylaxis in Healthcare Settings. Infection Control & Hospital Epidemiology. Published online 2025:1-11. doi:10.1017/ice.2025.10254
• Email:
  yct7@cdc.gov
• Peer Reviewed:
  True
• Collection(s):
  Guidelines and Recommendations National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:8b57246f55d968a20b2807e54c72388560a16e56be40153b65837f905ada9af01a11a7c31b2e6a9187895580fbeeaa36557319fa064c0c30cf8786618ab227d2
• Download URL:
  https://stacks.cdc.gov/view/cdc/183609/cdc_183609_DS1.pdf
• File Type:
  [PDF - 495.27 KB ]