Consent Form Hiv Test Page 27
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42Recommended HIV PEP
Percutaneous injuries
Infection status of the source
Exposure type
HIV-positive, Class 1 *
HIV-positive, Class 2*
Source of unknown
Unknown source
HIV-negative
HIV status
Asymptomatic HIV
Symptomatic HIV
(e.g. a needle from
infection or known
Infection, AIDS, acute
(e.g. deceased source
a sharps disposal
low viral load
seroconversion, or known
person with no samples
container)
(e.g., < 15,000)
high viral load.
available for HIV testing.
§
§
Recommend basi
c
Recommend expanded
No PEP warranted
Less Severe
†
†
Generally, no PEP
Generally, no PEP
2 – drug PEP
3 drug PEP
Warranted.
Warranted.
(e.g., solid needle,
superficial injury)
§
§
Recommend expa
nded
Rec
ommend expanded
No PEP warranted
More severe
†
†
G
enerally, no PE
P
Generally, n
o PEP
3 drug PEP
3 dru
g PEP
Warranted.
Warranted.
(e.g., large-bore hollow
needle, deep puncture,
visible blood on device, or
needle used in patient’s
artery or vein)
Mucous membrane exposu
res and non-intact skin
¶
ex
posures
Infection st atus of the source
Exposure type
HIV-positive, Class 1*
HIV-positive, Class 2*
Source of unknown
Unknown source
HIV-negative
HIV status
Asymptomatic HIV
Symptomatic HIV
(e.g. splash from
infection or known
Infection, AIDS, acute
(e.g. deceased source
inappropriately disposed
low viral load
seroconversion, or known
person with no samples
blood)
(e.g., < 15,000)
high viral load.
available for HIV testing.
§
§
Recommend basic
No PEP warranted
Sm ll v
a
olume
Consid
er basic
†
†
Generally, no PEP
Generally, no PEP
(e.g
., few
drops)
2 – drug PEP
†
2-drug PEP
Warranted.
Warranted.
§
§
Recommend basic
Recommen
d expanded
No PEP warranted
La
rge olume
v
†
†
Generally, no PEP
Generally, no PEP
(e.g
., major blood splash)
2 – drug PEP
3 drug PEP
Warranted.
Warranted.
* If drug resistance is a concern, obtain expert consultation. Initiation of PEP should not be delayed pending expert consultation and because expert consultati
on
alone cannot substitute for fact-to-face counseling, resources should be available to provide immediate evaluation and follow-up care for
all exposures.
†
The designation, “con
sider PEP,” indicates that PEP is optional and should be based on an individualized decision between the exposed person and the treating
clinician. Howeve
r, consider basic 2-drug PEP for a source with HIV risk factors, or occurs in a setting where exposure to HIV-infected persons is likely.
§
If PEP is offered and taken, and the source is later determined to be HIV negative, PEP should be discontinued.
¶
For skin exposures, follow-up is indicated only if there is evidence of compromised skin integrity (e.g., dermatitis, abrasion, or open wound).
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