Public Health Service Guidelines for the Management of Health-Care Worker Exposures to HIV and Recommendations for Postexposure Prophylaxis

Effective implementation of the elements of postexposure management detailed in these recommendations may require various types of expertise. The assessment of the severity of an exposure generally requires clinical training and experience (i.e., medical or nursing). However, the assessment of HIV infection risk and initiation of a basic PEP regimen necessitates knowledge or experience in clinical epidemiology, infection control, occupational health, or the clinical treatment of HIV. Decisions about HIV PEP are particularly complex if PIs are used or there is concern about drug-resistant virus. Thus, expert consultation when prescribing PEP is strongly encouraged. PEP protocols should list the names of readily available resources for consultation and could include policies that require infectious disease evaluation before prescribing an expanded antiretroviral regimen. However, these efforts should not delay initial implementation of PEP where it is appropriate.

Acknowledgments

Drafts of this document have been reviewed by many experts in the treatment of HIV infection and disease. We thank these consultants for their thoughtful comments, suggestions, and assistance.