A review of existing research confirms that health-care workers should undergo a month of preventive drug treatment if they are exposed// to HIV on the job.
Still, the reviewers say that there’s been little research into so-called occupational postexposure prophylaxis, and it’s still not clear what should be done when health-care workers are exposed to patients who are resistant to some drugs.
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
Doctors, nurses and other health-care providers have worried about HIV exposure since the AIDS epidemic first began in the early 1980s. Since the virus that causes AIDS is transmitted through blood, a simple needle stick could infect anyone treating a patient.
The risk, however, is quite low. The Centers for Disease Control and Prevention estimated in 2005 that the risk of HIV transmission through a contaminated needle stick is 0.3 percent, or about 1 chance in 333.
The low transmission risk may be related to two factors — the small amount of virus that gets into the body through health-care workers’ wounds and the barrier to the virus posed by the lower levels of the skin, said review co-author George Rutherford, M.D., of the University of California, San Francisco’s Institute for Global Health.
Still, a 1-in-333 risk is hardly insignificant. Many countries recommend postexposure prophylaxis, or PEP — in which doctors try to kill the virus in the body before it takes hold — if a health-care worker has been potentially exposed to HIV. The same approach is used to treat people who have been potentially exposed to HIV through sex.
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