Recommendations to Reduce the Risk of Occupational
HIV Transmission After an Exposure Incident

CE CREDIT IS NO LONGER AVAILABLE FOR THIS ACTIVITY

Target Audience

This activity is designed for physicians and nurses, and for other health care professionals who are involved in the care of individuals with HIV infection.

Release date: March 2006
Expiration date: June 2007

Statement of Need

The CDC published Updated U.S.Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis. [MMWR 2005;54 (No. RR-9)] on September 30, 2005. The CDC explained the need for new guidelines in this document as a concern for clinicians who treat health care workers and those who provide HIV medical care, who are essential consultants in selection of appropriate treatment regimens:

This report updates U.S. Public Health Service recommendations for the management of health-care personnel (HCP) who have occupational exposure to blood and other body fluids that might contain human immunodeficiency virus (HIV). Although the principles of exposure management remain unchanged, recommended HIV postexposure prophylaxis (PEP) regimens have been changed. This report emphasizes adherence to HIV PEP when it is indicated for an exposure, expert consultation in management of exposures, follow-up of exposed workers to improve adherence to PEP, and monitoring for adverse events, including seroconversion. To ensure timely postexposure management and administration of HIV PEP, clinicians should consider occupational exposures as urgent medical concerns.

The goal of this report is to provide recommendations for guiding clinical practice in managing PEP for health-care personnel (HCP) with occupational exposure to HIV.

Learning Objectives

Upon the completion of this activity, participants should be able to:

• Identify high-risk occupational HIV exposures for health care workers.
• Describe antiretroviral regimens to reduce the risk of occupational HIV transmission.
• Describe the appropriate use of HIV postexposure prophylaxis (PEP).
• List situations for which expert consultation in the management of occupational exposures is recommended.
  
  

Method of Instruction

Participants should read the learning objectives and review the activity in its entirety. After reviewing the material, complete the self-assessment test consisting of a series of multiple-choice questions. Upon completing this activity as designed and achieving a passing score of 70% or more on the self-assessment test, participants will receive an online CME credit letter awarding.

Accreditation

CE CREDIT IS NO LONGER AVAILABLE FOR THIS ACTIVITY

UMDNJ–Center for Continuing and Outreach Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

UMDNJ–Center for Continuing and Outreach Education designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

UMDNJ-Center for Continuing and Outreach Education is an approved provider of continuing education by the New Jersey State Nurses Association, Provider Number P173-10/06-09 . NJSNA is accredited by the ANCC Commission on Accreditation. This activity is approved for 1.2 contact hours. Provider approved by the California Board of Registered Nursing, Provider Number CEP 13780.

This activity was reviewed for relevance, accuracy of content, balance of presentation, and time required for participation by BeverlyAnn Collins, RN, MS, James W. Henry, BSN, Debbie M. Winters, MSN, APRN-BC, AACRN, and Patricia M. Kloser, MD, MPH.

Faculty

Sindy M. Paul, MD, MPH, is Medical Director for the New Jersey Department of Health and Senior Services (NJDHSS), Division of HIV/AIDS Services; Director of the Preventive Medicine: Public Health Residency Program at the NJDHSS; and Assistant Clinical Professor at the University of Medicine and Dentistry of New Jersey (UMDNJ).

Linda Berezny, RN, is a Supervising Program Development Specialist for the New Jersey Department of Health and Senior Services (NJDHSS), Division of HIV/AIDS Services.

Carol Lamond, RN, MS, is an industrial hygienist recently retired from the New Jersey Department of Health and Senior Services (NJDHSS), Occupational Health Service – Public Employees Occupational Safety and Health Program (PEOSH).

Disclosure

In accordance with the disclosure policies of UMDNJ and to conform with ACCME and FDA guidelines, all program faculty are required to disclose to the activity participants:

1. the existence of any financial interest or other relationships with the manufacturers of any commercial products/devices, or providers of commercial services, that relate to the content of their presentation/material, or the commercial contributors of this activity, that could be perceived as a real or apparent conflict of interest; and
2. the identification of a commercial product/device that is unlabeled for use or an investigational use of a product/ device not yet approved.

Faculty Disclosure Declarations

Patricia Kloser, MD, MPH (Field Tester and Activity Director) has the following financial relationships to disclose: Speaker’s Bureau: GlaxoSmithKline, Roche; Consultant: Gilead, Boehringer Ingleheim.

The following faculty and reviewers declare that they have no financial relationships with any corporate organization whose product(s) will be discussed in this presentation:
Linda Berezny, RN; BeverlyAnn Collins, RN, MS; James W. Henry, BSN; Carol Lamond, RN, MS; Sindy M. Paul, MD, MPH; and Debbie M. Winters, MSN, APRN-BC, AACRN..

Off-Label Usage Disclosure

This activity does not contain information of commercial products/devices that are unlabeled for use or investigational uses of products not yet approved.

Disclaimer

The views expressed in this activity are those of the faculty. It should not be inferred or assumed that they are expressing the views of NJDHSS-Division of HIV/AIDS Services, UMDNJ, or any manufacturer of pharmaceuticals.

The drug selection and dosage information presented in this activity are believed to be accurate. However, participants are urged to consult the full prescribing information on any agent(s) presented in this activity for recommended dosage, indications, contraindications, warnings, precautions, and adverse effects before prescribing any medication. This is particularly important when a drug is new or infrequently prescribed.

Copyright © 2006 UMDNJ-Center for Continuing and Outreach Education. All rights reserved including translation into other languages.

No part of this activity may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval systems, without permission in writing from UMDNJ-Center for Continuing and Outreach Education.

Grantor Acknowledgement

This activity is supported by an educational grant from NJDHSS Division of HIV/AIDS Services through a MOA titled, “Education and Training for Physicians and other Healthcare Professionals in the Diagnosis and Treatment of HIV/AIDS.”