XKC81579859

Postexposure prophylaxis with immediate antiretroviral therapy after penetrating injuries involving HIV-infected blood (needle sticks) or heavy mucous membrane (eye or mouth) contamination is believed to reduce transmission. Combinations of a protease inhibitor with two nucleoside reverse transcriptase inhibitors are currently recommended for postexposure prophylaxis of relatively high-risk exposures. Zidovudine (ZDV or AZT) appeared to reduce risk of transmission after needle-stick injuries in one study, which provided the only evidence that prophylaxis works. Because of the low risk of infection for most injuries, controlled prospective studies of the effectiveness of prophylaxis are not practical. Cancers or birth defects from the brief exposures to these drugs have not been found in the small numbers of otherwise healthy persons who have used ZDV for this purpose. Because some women in early pregnancy will be offered postexposure prophylaxis before their pregnancy is suspected or confirmed, special caution must be exercised in treating potentially pregnant women. Additional problems arise when the source or HIV status of blood is unknown, but identification of the source and testing of that person for HIV infection should be vigorously pursued.