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17 - HIV postexposure prophylaxis for pediatric patients

Published online by Cambridge University Press:  23 December 2009

By
Peter L. Havens  and
Kenneth L. Dominguez
Edited by
Steven L. Zeichner  and
Jennifer S. Read
Peter L. Havens
Affiliation:
Medical College of Wisconsin and MACC Fund Research Center, Milwaukee, WI
Kenneth L. Dominguez
Affiliation:
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Steven L. Zeichner
Affiliation:
National Cancer Institute, Bethesda, Maryland
Jennifer S. Read
Affiliation:
National Institutes of Health, Bethesda, Maryland
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Summary

Introduction

This chapter addresses HIV postexposure prophylaxis (PEP) in the following situations: injury from discarded needles, bite wounds, sexual exposure, and inadvertent exposure to human milk from an HIV-infected woman. In each setting, the risk of HIV transmission is directly related to the probability that the exposure source has HIV infection and that transmission of a sufficient amount of infectious virus occurred in a manner that could result in infection in the recipient. Because no studies have directly measured the effectiveness of PEP in decreasing the risk of HIV transmission in non-occupational settings or after mucosal exposure, the potential benefit of PEP in modifying transmission risk is extrapolated from data regarding HIV pathogenesis in animals, from information about PEP for needle-stick injuries in occupational settings, and from studies of mother-to-child transmission (MTCT) of HIV. Guidelines for prophylaxis after exposure to HIV in occupational and non-occupational settings have been published by the US Public Health Service (USPHS) [1–3], the American Academy of Pediatrics [4], the NY State Department of Health [5], and others [6].

Factors affecting HIV transmission risk after potential exposure

Type of source material

Not all body fluids from persons with HIV infection are equally infectious (Table 17.1). Blood and fluids contaminated with blood from persons with HIV infection are assumed to contain HIV and are associated with the highest risk of HIV transmission.

Type
Chapter
Information
Handbook of Pediatric HIV Care , pp. 450 - 470
Publisher: Cambridge University Press
Print publication year: 2006

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References

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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

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