Occupational HIV Exposure During Primary Infection

Direct HIV-detection tests are needed when evaluating occupational exposure to blood of patients who may have primary HIV infection.

CDC guidelines for postexposure prophylaxis (PEP) rely on HIV antibody testing of source patients. However, HIV-antibody tests are often negative during primary HIV infection, during which time viral load may be high. Investigators in Switzerland now report two recent cases of occupational exposure to the blood of patients with primary HIV infection and review the literature to highlight two additional case reports.

In both new cases, healthcare workers sustained deep percutaneous injuries while handling blood from source patients with primary HIV infection. Although the source patients were HIV-antibody–negative and Western blot–negative at the time of exposure, both tested positive for p24 antigen and had high viral loads by PCR. The healt…

Reviewing Author

Daniel J. Diekema, MD, MS