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Health-Care Workers Exposed to HIV on Job Need Preventive Treatment

ection makes it difficult for researchers to find enough people to study the effectiveness of postexposure treatment, Rutherford said. He added that, not surprisingly, exposed health-care workers haven’t been willing to take part in any study that might result in their taking a placebo instead of drug treatment.

The researchers were only able to find a single study that compared those who took drugs after exposure to those who didn’t.

That study, of 712 exposed health-care workers, found that the odds of becoming infected with HIV were reduced by about 81 percent among those who took zidovudine — an anti-HIV drug also known as AZT or Retrovir — after exposure. The study also reported that the odds of HIV infection were higher if a health-care worker had a deep injury, if there was visible blood on the device (such as a needle), if the needle had been placed in the infected patient’s blood vessel or if the patient was terminally ill. A deep injury appeared to be by far the most dangerous of the factors.

HIV patients typically take more than one drug, and doctors prescribe multiple drugs as prophylaxis for exposed health-care workers, too. While there’s no research suggesting whether that’s a good idea in the latter case, the reviewers still recommend a multiple-drug regimen because it works in HIV-infected patients.

Questions still remain, however, about what to do if an HIV patient is resistant to existing medications. “That is,” Rutherford asked, “what do you do if you know a patient is not susceptible to the first-line drugs?”

There’s also the matter of side effects, which can keep people from wanting to continue on HIV drugs for the recommended full month.

For now, Rutherford recommends that health-care workers follow federal guidelines regarding the risk of HIV infection from needle sticks.

Still, the risk of an infection seems likely to never go away. An estimated 26 percent
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