Advertisement
The Body: The Complete HIV/AIDS Resource
Follow Us Follow Us on Facebook Follow Us on Twitter Download Our App
Professionals >> Visit The Body PROThe Body en Espanol
Read Now: TheBodyPRO.com Covers AIDS 2014
   
Ask the Experts About

Choosing Your MedsChoosing Your Meds
           
Rollover images to visit our other forums!
Recent AnswersAsk a Question
  
  • Email Email
  • Glossary Glossary


Infection via eye mucosa and PEP-Follow up please
May 29, 2009

Dear dr. Young

Thank you for your swift answer. I decided not take PEP, since the source patient was of unknown HIV status and the source patient was with low HIV risk factors ( married family women with a 3 year old child). (I knew I could have asked her to be tested but in my country there is quite stigma about HIV).

When I looked at recommendations from the CDC: "Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis", I found out that they did not recommend the PEP in case of source of unknown HIV status in case of mucous membrane exposures regardless of volume.

They made a distinction between small volume and large volume saying that only in case of large volume of unknown source one should consider PEP for source with high HIV risk factors. In case of small volume they simply did not recommend PEP when source was unknown ( not going into hiv risk factors analysis).

So I guess that CDC concluded that a sum of overall risk 0.1% combined with small volume ( probably low end spectrum of the interval with mean of 0.1%) and unknown status of source makes such risks quite remote, that even HIV risk factors for source patient are not to be analyzed ( with small volume).

I do understand your position in answering my question as I would never not recommend PEP in case of possible exposure regardless of how remote it was.

Could you please comment on the CDC position of not recommending PEP in case of mucous membrane exposure if source is of unknown status or if the source was unknown.

Kind regards and many thanks.

Response from Dr. Young

Thanks for the follow up; I'm never one to try to interpret the CDC, but I think it has to come from a relative risk standpoint and one that is based more on non-occupational exposure rather than a medical exposure (ie, with fluids that are often derived from percutaneous devices).

Part of the issue is what the relative risk of HIV infection is in the population of "unknowns" that are under care- in your case, perhaps lower, but sounds like you might not be in the US (or EU?); my knowledge of the relative risks or epidemiology among such individuals is low. The way I look at it is risk is largely binary. If there was sufficient basis to think that there might be exposure, then I'll recommend PEP.

I'm not sure that this provides a definitive answer to your question, just background.

Be well, BY



Previous
Risk of Resistance After Stopping Meds
Next
Once AIDS, always AIDS?

  
  • Email Email
  • Glossary Glossary

 Get Email Notifications When This Forum Updates or Subscribe With RSS


 
Advertisement



Q&A TERMS OF USE

This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

Review our complete terms of use and copyright notice.

Powered by ExpertViewpoint

Advertisement