Tuesday, December 6, 2011

CDC recommendations for Post Exposure to Blood Borne Pathogens

• Wounds and skin sites that have been in contact with blood or body fluids should be washed with soap and water; mucous membranes should be flushed with water.
• The person whose blood or body fluid is the source of an occupational exposure should be evaluated for HBV, HCV and HIV infection.
• Post-exposure treatment should begin within 24 hours and not later than 7 days.
• Recommendations for HBV post-exposure management include initiation of the hepatitis B vaccine series to any susceptible, unvaccinated person who sustains an occupational blood or body fluid exposure. Post-exposure prophylaxis (PEP) with hepatitis B immune globulin (HBIG) and/or hepatitis B vaccine series should be considered for occupational exposures after evaluation of the hepatitis B surface antigen status of the source and the vaccination and vaccine-response status of the exposed person.
• There is no post-exposure treatment that will prevent HCV infection. For the person exposed to an HCV-positive source perform baseline testing for anti-HCV and ALT activity; and perform follow-up testing (e.g., at 4–6 months) for anti-HCV and ALT activity (if earlier diagnosis of HCV infection is desired, testing for HCV RNA may be performed at 4–6 weeks). Immune globulin and antiviral agents (e.g., interferon with or without ribavirin) are not recommended for PEP of hepatitis
• Recommendations for HIV PEP include a basic 4-week regimen of two drugs (zidovudine and lamivudine, lamivudine and stavudine or didanosine and stavudine) for most HIV exposures and an expanded regimen that includes the addition of a third drug for HIV exposures that pose an increased risk for transmission.

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