Healthcare Exposures

    Table of contents
    1. 1. HIV
    2. 2. Hep B
    3. 3. Hep C

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    HIV

    • Only 56 cases of symptomatic HIV have been confirmed to have been transfered by healthcare contact in US.
    • Transmission very unlikely.
    • Post-Exposure Prophylaxis (PEP) is anti-retroviral drugs (2 drugs or 3 drugs depending on type of contact)
      • 2 drugs if: source likely has HIV (risk factors) OR source has asymptomatic HIV
      • 3 drugs if: source has symptomatic HIV OR source HIV positive asymptomatic but exposure is severe
      • No PEP: if source unlikely to have HIV
    • If HIV status of source is unknown: do rapid HIV antibody test (later confirm with Western Blot)
    • Source: The Little ICU book

     

    Hep B

    • Most readily transmitted bloodborne infection.
    • Vaccine = lifelong immunity
    • PEP = Vaccine (only contraindication is anaphylaxis allergy to baker's yeast)
      • 3 doses (First two doses 4w apart, then 5mo later

     

    Hep C

    • Risk of transmission after a needle-stick injury is 1.8% (mucous transmission is very rare, and no documented skin-break tranmission)
    • No PEP for HepC
      • Measure Anti-HCV antibodies serially for 6mo
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