Correct understanding of the concept of "exposure"

This is an automatically translated article.

Exposure is the term used by the Department of Health to refer to contact of mucous membranes or intact skin with blood, tissues or other body fluids at risk of HIV transmission.

1. What is exposure?

According to the definition of the Ministry of Health, HIV exposure is a term used to refer to the contact of the mucous membranes or skin of an uninfected person with the blood, tissues or body fluids of another person, leading to the risk of HIV infection. .
Situations known as HIV exposures:
When medical procedures such as infusions or blood tests are punctured by a needle . Wounds caused by scalpels or sharp instruments poke or puncture causing bleeding. Injury to the skin by punctured tubes containing the patient's blood or fluids. Blood or fluids of a person with HIV splashes into damaged skin areas, into mucous membranes: eyes, nose, throat. Being stabbed by someone else using a used syringe that has blood and contains HIV virus, or people while on duty such as police, doctor, traffic accident emergency, arresting criminals, ... When having sex with someone who has HIV without using a condom. In fact, not every person exposed to HIV will become infected with HIV. This will depend on the specific behavior and how risky it is. When faced with a risk situation, post-exposure management is very important, has special meaning, helps you and your loved ones limit the risk of HIV infection.

2. Exposure handling procedures

2.1 Local wound treatment With bleeding skin lesions:
Immediately wash the wound under running water. Let the wound bleed for a short time. Wash thoroughly with soap, disinfect with antiseptic solutions (Dakin, Javen 1/10 or medical alcohol) for at least 5 minutes. If exposed through eye mucosa: Flush with distilled water or 0.9% NaCL saline continuously for 5 minutes.
Exposure through mucous membranes of the mouth and nose:
Wash with distilled water or saline 0.9% NaCL Rinse mouth with 0.9% NaCL water several times. 2.2 Assessment of exposure risk High risk :
Deep skin damage, heavy bleeding Blood and fluids from HIV infected person splashing on wounds, extensive mucosal ulceration Low risk :
Skin damage superficial abrasions and no or very little bleeding Blood and body fluids splash into undamaged mucosa, ulcers No risk : Blood and body fluids splash into healthy skin, and not hurt.

3. Treatment of exposure with antiretroviral (ARV) drugs

For those who are not at risk of infection, no treatment is needed. For low-risk or high-risk cases, ARV prophylaxis can be used.
It is necessary to initiate ART immediately for exposed persons, especially those at high risk of infection, as soon as possible. It is best to start ART as early as 2-6 hours after exposure and not as late as 72 hours. The duration of ART lasts for four weeks and the following regimens can be used as prescribed by the doctor: ZDV + 3TC or d4T + 3TC.
Currently, only cases of exposure while on professional duty can receive free preventive treatment, while community exposure cases are not granted this regime. However, those exposed can buy the drug at pharmacies as prescribed by a doctor.
During ARV prophylaxis, it is necessary to monitor side effects of ARV drugs through the following tests: Blood count test, measurement of liver enzymes ALT / SGPT at the beginning of treatment and after treatment is completed. two weeks, blood sugar test. Also, the exposed person should be tested for HIV one, three and six months after exposure.
During this time, the exposed person should take precautions to prevent infecting others. After 6 months of HIV testing and negative results, the exposed person can rest assured that there was no HIV infection in that situation.
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