Clinical Observation
December 10/24, 2007

The TrapProfessional Exposure to Human Immunodeficiency Virus Antibody–Negative Blood With High Viral Load

Author Affiliations

Author Affiliations: Service of Infectious Diseases (Drs Giulieri and Cavassini) and Laboratory of Immunology and Allergy (Dr Burgisser), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland; and Division of Infectious Diseases (Drs Schiffer and Hirschel) and Laboratory of Virology, Division of Infectious Diseases (Dr Yerly), University Hospital of Geneva, Geneva, Switzerland.


Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007

Arch Intern Med. 2007;167(22):2524-2526. doi:10.1001/archinte.167.22.2524

The Centers for Disease Control and Prevention, national public health agencies, and an expert committee of the European Commission have recently published updated guidelines on postexposure prophylaxis (PEP) of occupational human immunodeficiency virus (HIV) exposure.1,2 Management of occupational HIV exposure relies heavily on HIV antibody testing of the source patient. However, patients with acute HIV infection may be antibody negative yet particularly contagious because of high viremia. We report 2 cases involving health care workers who were exposed to patients with acute primary HIV infection (PHI). The patients were in the “window period” of seroconversion, during which detection of HIV p24 antigen provided the definitive indication for PEP. We also review the literature on the topic.

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