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The US Centers for Disease Control and Prevention (CDC) has published guidelines for preventive treatment of healthcare workers accidentally exposed to HIV (for example, by being stuck with
a contaminated needle). While these official guidelines do not discuss persons exposed through sex or sharing needles, many experts agree that the situations are similar and the same preventive treatment should be used.
The new guidelines call for four weeks of treatment, with either two drugs (AZT plus 3TC) or three drugs (AZT plus 3TC, plus either indinavir or nelfinavir). Whether to use two drugs or three-- or no
treatment at all-- depends on the seriousness of the exposure.
The guidelines include a procedure for deciding what prophylaxis is needed.
Treatment to prevent infection must be started as soon as possible, preferably within a few hours of exposure, certainly before 24-36 hours, since animal studies suggest that later treatment might not
prevent infection.
When starting drugs immediately is not possible, the guidelines still recommend a later start in some situations, since very early treatment of HIV may be beneficial, even if it is too late to prevent the infection.
For advice in managing postexposure prophylaxis, clinicians should consult local HIV experts, or call the National Clinicians' Postexposure Hotline, 888-448-4911.
Editor's Note: from AIDS Treatment News
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