Preventing HIV infection after exposure

September 9, 2009 3:17:05 PM PDT
A new medical room tool was rolled out at one New York hospital Wednesday, and it may soon be in many more. It's a tool to help doctors effectively test or treat patients who may have been exposed to the virus that causes AIDS. Two doctors came up with the tool, and it is to educate medical professionals how to treat patients who may have been exposed to HIV. It's not well known by the general public, but there is a therapy that could prevent someone from getting infected with the virus if they have had an exposure.

There is a combination of three or four medications that can be given to someone exposed to HIV that may prevent infection. For years, they've been used in hospitals for medical professionals who may suffer an accidental exposure, in needle pricks, for example. And in some cases, they've also been used with people exposed through drugs or sex.

The therapy is called PEP, which stands for post exposure propylaxis. Prophylaxis is the medical word meaning disease prevention.

"It's a series of medications called anti-retrovirals that patients take for 28 days daily," said Dr. Tony Ubrina, of St. Vincent's Hospital.

Dr. Urbina and his colleague Paul Galatowitsch on Wednesday unveiled a new computer program at St. Vincent's Hospital.

It is meant to help help doctors and other medical professionals understand and use PEP.

Non-occupational PEP, or NPEP, is used with those who've been exposed outside a medical setting, through sex or drug use, for example.

St. Vincent's Hospital has treated dozens of patients for non-occupational exposure to HIV.

Dr. Daniel Egan worked in the emergency room.

"At St. Vincent's, there were a number of patients who presented looking forward for post exposure prophylaxis in an non-occupational setting, most commonly sexual exposure," he said. "However, if you move to a different demographic, it's not as common for people to present."

Post exposure propylasis is not an optimal therapy. The medicine has side effects and many can't continue the combination of drugs daily for one month.

Still, this information program, developed with state funds, is available for use.

"We would like that every single hospital, community health center and any other clinical institution will have it, use it, and we will give it to them free of charge," said Armando Cruz, of the AIDS Institute.

The use of non-occupation PEP is not without controversy. There are no studies that show it works in this particular setting, because HIV exposure at work is usually a one-time accident. Some think the idea that PEP is available might encourage unsafe behavior.

In any event, this program might allow more doctors to use it.

The New York State Department of Health AIDS Institute's clinical education initiative is designed to meet the HIV educational needs of providers throughout New York State. For more information, visit

The CDC guidelines for PEP use are also posted on the Web. For occupational exposure, CLICK HERE. For non-occupational exposure, CLICK HERE.



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