Interim Statement Regarding Potential Fetal Harm from Exposure to Dolutegravir – Implications for HIV Post-exposure Prophylaxis (PEP). Please see attached statement (PDF of Dolutegravir attached).

Several corrections have been made to this PDF since online publication of the “Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis” in Infection Control and Hospital Epidemiology on August 6, 2013 (ICHE 2013; 34(9):875-892). Three errors have been corrected: 1. In the Appendix B Table, in row 1, “Abacavir”, under column 3, “Dosing (dosage form)”, “300 mg daily” was incorrect and was changed to the correct recommended dose of Abacavir: “600 mg daily.”; 2. In the Appendix B Table, in row 17, “Tenofovir DF”, under column 5, “Disadvantages”, the text immediately following “Nephrotoxicity” was deleted: “should not be administered to individuals with acute or chronic kidney injury or those with eGFR <60.”; 3. The affiliation for Dr. Ahmed Gomaa was corrected from “Division of Surveillance, Hazard Evaluation, and Health Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio.,” to “Division of Surveillance, Hazard Evaluation, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio.”

This report updates U.S. Public Health Service recommendations for the management of health-care personnel (HCP) who have occupational exposure to blood and/or other body fluids that might contain human immunodeficiency virus (HIV). Although the principles of exposure management remain unchanged, recommended HIV postexposure prophylaxis (PEP) regimens and the duration of HIV follow-up testing for exposed personnel have been updated. This report emphasizes the importance of primary prevention strategies, the prompt reporting and management of occupational exposures; adherence to recommended HIV PEP regimens when indicated for an exposure; expert consultation in management of exposures; follow-up of exposed HCP to improve adherence to PEP; and careful monitoring for adverse events related to treatment, as well as for virologic, immunologic and serologic signs of infection. To ensure timely postexposure management and administration of HIV PEP, clinicians should consider occupational exposures as urgent medical concerns, and institutions should take steps to ensure that staff are aware of both the importance of, and the institutional mechanisms available for, reporting and seeking care for such exposures.

The material in this report originated in the National Center for Emerging and Zoonotic Infectious Diseases, Beth Bell, MD, Director; Division of Healthcare Quality Promotion, Denise M. Cardo, MD, Director

Running title: US PHS guidelines for the management of occupational exposures to HIV.

Appendix A: HIV postexposure prophylaxis regimens -- Appendix B: Information on HIV postexposure prophylaxis medications.

9/25/13 – date from document properties

48 numbered pages

9/25/2013 Update (May 23, 2018)