Management of Occupational Exposure to HIV in Dental Health Care Workers

Health care workers (HCW) are at high risk of occupational exposure from blood-borne pathogens. The most important pathogens that can be transmitted to HCW are HIV with prevalence of 2.24 per 100000, HBV with prevalence of 2.3%, and HCV with prevalence of 0.2% in Iran. Most of this occupational transmission can be prevented through standard precautions reducing exposure. These precautions, however, have not been able to obviate the problem due to the risk of infection through accidental exposure. Risk of HIV infection in these cases has been estimated to be 0.2-0.3 percent for parenteral exposure. If an accidental exposure occurs, there are some post-exposure prophylaxis (PEP) protocols that reduce the risk of transmission. The PEP protocol consists of report of needle sticks injury, prescription of two or three antiretroviral agents in the first 48 hours after exposure, and antibody testing of HCW for seroconversion up to six month. Health care workers have to be educated about PEP and each institution needs to adopt a clear protocol.