Explaining postexposure prophylaxis to HCWs
Recommendations for chemoprophylaxis should be explained to health care workers who have sustained occupational HIV exposures. (See recommendations, inserted in this issue.) When postexposure prophylaxis (PEP) is considered appropriate, HCWs should be informed of the following:
· Knowledge about the efficacy and toxicity of drugs used for PEP is limited.
· Only zidovudine has been shown to prevent HIV transmission in humans.
· There are no data to address whether adding other antiretroviral drugs provides any additional benefit for PEP, but experts recommend combination drug regimens because of increased potency and concerns about drug-resistant virus.
· Data regarding toxicity of antiretroviral drugs in persons without HIV infection or in pregnant women are limited for zidovudine and not known for other antiretroviral drugs.
· Any or all drugs for PEP may be declined by the HCW.
Workers with occupational exposures for which PEP is not recommended should be advised that potential side effects and toxicity of taking PEP outweigh the negligible risk of HIV transmission posed by the exposure.
Source: Centers for Disease Control and Prevention. Public Health Service guidelines for the management of health-care worker exposures to HIV and recommendations for postexposure prophylaxis. MMWR 1998; 47(No. RR-7):1-33.
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