Management of Occupational Exposure to the Human Immunodeficiency Virus

Much concern exists among health care workers about the possibility of occupational acquisition of human immunodeficiency virus (HIV) infection. Throughout the United States, several hundred health care workers who have experienced documented exposures to blood or other body fluids of persons infected with HIV have been followed prospectively. Results from these studies have demonstrated that the risk of HIV transmission associated with a single percutaneous exposure is on the average 0.33% (approximately 1 infection for every 350 exposures).1–4 Most efforts to prevent occupational HIV infection have focused on universal infection control precautions to reduce the incidence of occupational exposures.5 Strict adherence to these recommendations will reduce, but may not completely eliminate, the risk of such exposures. Additional recommendations have been made for management of health care workers following occupational exposure to blood from HIV-infected patients.6,7 This chapter focuses on elements of postexposure management and discusses issues regarding the use of prophylactic zidovudine.