CDC suggestions for HIV-infected needlesticks

The Centers for Disease Control and Prevention says chemoprophylaxis with ZDV, 3TC, and IDV should be recommended to health care workers who sustain "highest" or "increased" risk needlestick exposure.

For the increased risk category, however, the possible toxicity of IDV should be considered before proceeding. In that regard, a combination of only ZDV and 3TC should be offered for needlesticks defined as "no increased risk." CDC definitions of the risk categories for needlesticks involving HIV-infected blood are summarized as follows:

* Highest risk exposures: Have both a larger volume of blood (i.e., deep injury with a larger diameter hollow needle previously in source patient's vein or artery) and blood containing a high titer of HIV (i.e. source patient with end-stage AIDS).

* Increased risk exposures: Either exposure to larger volume of blood or blood with a higher viral titer of HIV.

* No increased risk: Neither exposure to larger volume of blood nor blood with a high titer of HIV (i.e., solid suture needle injury from source patient with asymptomatic HIV infection).

Reference

1. Centers for Disease Control and Prevention. Update: Provisional public health service recommendations for chemoprophylaxis after occupation exposure to HIV. MMWR 1996: 45: 468-472. *