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Public Health Service Guidelines for the Management of Possible Sexual, Injecting-Drug-Use, or Other Nonoccupational Exposure to HIV, Including Considerations Related to Antiretroviral Therapy

September 25, 1998


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  2. CDC. 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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  6. Tokars JI, Marcus R, Culver DH, et al., for the CDC Cooperative Needlestick Surveillance Group. Surveillance of HIV infection and zidovudine use among health care workers after occupational exposure to HIV-infected blood. Ann Intern Med 1993;118:913-9.

  7. Mastro TD, de Vincenzi I. Probabilities of sexual HIV-1 transmission. AIDS 1996;10(suppl A):S75-S82.

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  11. Saag MS. Candidate antiretroviral agents for use in postexposure prophylaxis. Am J Med 1997;102:25-31.

  12. Black RJ. Animal studies of prophylaxis. Am J Med 1997;102:39-44.

  13. Martin LN, Murphey-Corb M, Soike KF, Davison-Fairburn B, Baskin GB. Effects of initiation of 3'-azido,3'-deoxythmidine (zidovudine) treatment at different times after infection of rhesus monkeys with simian immunodeficiency virus. J Infect Dis 1993;168:825-35.

  14. McClure HM, Anderson DC, Ansari AA, Fultz PN, Klumpp SA, Schinazi RF. Nonhuman primate models for evaluation of AIDS therapy. Ann N Y Acad Sci 1990;616:287-98.

  15. Tsai C-C, Follis KE, Grant RF, et al. Effect of dosing frequency on ZDV prophylaxis in macaques infected with simian immunodeficiency virus. J Acquir Immune Defic Syndr 1993;6:1086-92.

  16. Watson A, McClure J, Ranchalis J, et al. Early postinfection antiviral treatment reduces viral load and prevents CD4+ cell decline in HIV type 2-infected macaques. AIDS Res Hum Retroviruses 1997;13:1375-81.

  17. Tsai C-C, Folis KE, Sabo A, et al. Prevention of SIV infection in macaques by (R)-9-(2-phos-phonylmethoxypropyl) adenine. Science 1995;270:1197-9.

  18. Tsai C-C, Emau P, Folis KE, et al. Effectiveness of postinoculation (R)-9-(2-phosphonyl-methoxypropyl) adenine treatment for prevention of persistent simian immunodeficiency virus SIVmne depends critically on timing of initiation and duration of treatment. J Virol 1998;72:4265-73.

  19. Böttiger D, Johansson N-G, Samuelsson B, et al. Prevention of simian immunodeficiency virus, SIVsm' or HIV-2 infection in cynomolgus monkeys by pre- and postexposure administration of BEA-005. AIDS 1997;11:157-62.

  20. CDC. Case-control study of HIV seroconversion in health-care workers after percutaneous exposure to HIV-infected blood -- France, United Kingdom, and United States, January 1988-August 1994. MMWR 1995;44:929-33.

  21. Cardo DM, Culver DH, Ciesielski CA, et al., and CDC Needlestick Surveillance Group. A case-control study of HIV seroconversion in health care workers after percutaneous exposure. N Engl J Med 1997;337:1485-90.

  22. Henderson DK. Postexposure treatment of HIV -- taking some risks for safety's sake [Editorial]. N Engl J Med 1997;337:1542-3.

  23. Jochimsen EM. Failures of zidovudine postexposure prophylaxis. Am J Med 1997;102:52-5.

  24. Sperling RS, Shapiro DE, Coombs RW, et al., for the Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. Maternal viral load, zidovudine treatment, and the risk of transmission of human immunodeficiency virus type 1 from mother to infant. N Engl J Med 1996;335:1621-9.

  25. CDC. Administration of zidovudine during late pregnancy and delivery to prevent perinatal HIV transmission -- Thailand, 1996-1998. MMWR 1998;47:151-4.

  26. Connor EM, Sperling RS, Gelber R, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Eng J Med 1994;331:1173-80.

  27. Food and Drug Administration. Protease inhibitors may increase blood glucose in HIV patients. Rockville, MD: Food and Drug Administration; Summer 1997. FDA Medical Bulletin 27.

  28. Ippolito G, Puro V, and the Italian Registry of Antiretroviral Prophylaxis. Zidovudine toxicity in uninfected healthcare workers. Am J Med 1997;102:58-62.

  29. Forseter G, Joline C, Wormser GP. Tolerability, safety, and acceptability of zidovudine prophylaxis in health care workers. Arch Intern Med 1994;154:2745-9.

  30. Wang SA and the HIV PEP Registry Group. Human immunodeficiency virus (HIV) postexposure prophylaxis (PEP) following occupational HIV exposure: Findings from the HIV PEP Registry [Abstract 482]. In Program and abstracts of the Infectious Diseases Society of America 35th Annual Meeting. San Francisco: Infectious Diseases Society of America, 1977:161.

  31. Steger KA, Swotinsky R, Snyder S, Craven DE. Recent experience with post-exposure prophylaxis (PEP) with combination antiretrovirals for occupational exposure (OE) to HIV [Abstract 480]. In Program and abstracts of the Infectious Diseases Society of America 35th Annual Meeting. San Francisco: Infectious Diseases Society of America, 1977:161.

  32. The HIV Postexposure Prophylaxis Registry. Interim report 17 October through 1 March 1998. The HIV Postexposure Prophylaxis Registry. Registry of health-care workers receiving postex-posure prophylaxis after occupational exposure to human immunodeficiency virus. Wilmington, NC: The HIV Postexposure Prophylaxis Registry; August 10, 1997.

  33. Beekman R, Fahrner R, Nelson L, Henderson DK, Gerberding JL. Combination post-exposure prophylaxis (PEP): A prospective study of HIV-exposed health care workers (HCW) [Abstract 481]. In Program and abstracts of the Infectious Diseases Society of America 35th Annual Meeting. San Francisco: Infectious Diseases Society of America, 1977:161.

  34. Hirsch MS, Klibanski A. Editorial response: What price progress? Pseudo-Cushing's syndrome associated with antiretroviral therapy in patients with human immunodeficiency virus infection. Clin Infect Dis 1998;27:73-5.

  35. Lipsky JJ. Abnormal fat accumulation in patients with HIV-1 infection. Lancet 1998;351:847-8.

  36. Carr A, Samaras K, Burton S, et al. A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS 1998;12:F51-F58.

  37. Dubé MP, Johnson DL, Currier JS, Leedom JM. Protease inhibitor-associated hyperglycemia [Letter]. Lancet 1997;350:713-4.

  38. Henry K, Acosta EP. Jochimsen E. Hepatotoxicity and rash associated with zidovudine and zalcitabine chemoprophylaxis [Letter]. Ann Intern Med 1996;124:855.

  39. Dilly JW, Woods WJ, McFarland W. Are advances in treatment changing views about high-risk sex? [Letter]. N Engl J Med 1997;337:501-2.

  40. Holtgrave DR, Pinkerton SD. Updates of cost of illness and quality of life estimates for use in economic evaluations of HIV prevention programs. J Acquir Immune Defic Syndr Hum Retrovirol 1997;16:54-62.

  41. Holtgrave DR, Kelly JA. Preventing HIV/AIDS among high-risk urban women: the cost-effectivenes of a behavioral group intervention. Am J Public Health 1996;86:1442-5.

  42. Pinkerton SD, Holtgrave DR, Bloom FR. Postexposure treatment of HIV [Letter]. N Engl J Med 1997;337:500-1.

  43. Li RW, Wong JB. Postexposure treatment of HIV [Letter]. N Engl J Med 1997;337:499-500.

  44. Opio G, Torres R, Alvalle R. Post-sexual exposure prophylaxis (PSEP) with HAART after sexual assault [Abstract 250/33174]. 12th World AIDS Conference. Geneva, Switzerland, June-July 1998.

  45. Gostin LO, Lazzarini Z, Alexander D, Brandt AM, Mayer KH, Silverman DC. HIV testing, counseling, and prophylaxis after sexual assault. JAMA 1994;271:1436-44.

  46. Buchbinder SP, Douglas JM, McKirnan DJ, Judson FN, Katz MH, MacQueen KM. Feasibility of human immunodeficiency virus vaccine trials in homosexual men in the United States: Risk behavior, seroincidence, and willingness to participate. J Infect Dis 1996;174:954-61.

  47. Hammett TM, Widom R, Epstein J, Gross M, Sifre S, Enos T. 1994 update: HIV/AIDS and STDs in correctional facilities. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National Institute of Justice, 1995. NCJ 156832.

  48. Bertolli JM, Hsu H, Frederick T, et al. Breastfeeding among HIV-infected women, Los Angeles and Massachusetts, 1988-1993 [Abstract We.C.3583]. Presented at the XI International Conference on AIDS. Vancouver, British Columbia, July 1996:158.

  49. CDC. 1998 Guidelines for treatment of sexually transmitted diseases. MMWR 1998;47(No. RR-1): 1-116.

  50. American College of Obstetrics and Gynecology. Sexual Assault. Washington, DC: American College of Obstetrics and Gynecology; 1992. ACOG Technical Bulletin 172.

  51. Trussel J, Koenig J, Ellertson C, and Stewart F. Preventing unintended pregnancy: the cost-effectiveness of three methods of emergency contraception. Am J Public Health 1997;87:932-7.

  52. CDC. Technical guidance on HIV counseling. MMWR 1993;42(No. RR-2):8-17.

  53. CDC. U.S. Public Health Service recommendations for human immunodeficiency virus counseling and voluntary testing for pregnant women. MMWR 1995;44(No. RR-7):1-15.

  54. CDC. Public Health Service Task Force recommendations for the use of antiretroviral drugs in pregnant women infected with HIV-1 for maternal health and for reducing perinatal HIV-1 transmission in the United States. MMWR 1998;47(No. RR-2):1-30.

  55. CDC. Report of the NIH panel to define principles of therapy of HIV infection and Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents. MMWR 1998;47(No. RR-5):1-82.

  56. CDC. Guidelines for the use of antiretroviral agents in pediatric HIV infection. MMWR 1998;47(No. RR-4):1-44.

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This article was provided by U.S. Centers for Disease Control and Prevention. It is a part of the publication Morbidity and Mortality Weekly Report. Visit the CDC's website to find out more about their activities, publications and services.