This conference follows two needlestick exposure cases: one involving a healthcare worker exposed to blood from a source patient with well-controlled HIV, and another involving a pregnant patient with exposure to a reported HIV/HCV-positive source. The first case highlights the practical tension between starting HIV PEP quickly, assessing source-patient viral suppression, and managing significant side effects including GI intolerance and transaminitis.
The teaching portion reviews immediate post-exposure steps, baseline labs for the exposed patient, what to ask about the source patient, HIV PEP timing and regimen selection, HBV prophylaxis when anti-HBs is absent, and HCV follow-up. The pregnancy case adds discussion of PEP safety in pregnancy, what to do if delivery occurs before the source evaluation is complete, and how to communicate risk and urgency to consulting teams.