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Case 3: Management of a Needlestick Injury: Source Patient of Unknown Serostatus

You answered:

D Offer PEP with zidovudine plus lamivudine (Combivir) and perform HIV testing on the source patient as soon as it is possible.

This answer is correct. The current 2005 U.S. Public Health Service guidelines for postexposure prophylaxis suggest that a basic, 2-drug PEP regimen should be considered for occupational exposures involving a source patient of unknown serostatus who has risk factors for HIV infection. Many experts, however, would consider initiating therapy with a 3-drug PEP regimen in this setting. If subsequent testing reveals the source patient is not infected with HIV, then the health care worker should discontinue PEP.


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