WE NEED SOME ONE TO GUIDE US THIS IS FOGSI EFFORT SINCE 2008...THE FIRST HELP LINE OF ITS KIND IN THE WORLS

1. FOGSI HIV PEP
HELPLINE
Dr.Narendra Malhotra
FOGSI coordinator for PEP Helpline
Dr. Alok Vashishtha
Consultant in Infectious Diseases
Haridwar

2. What is Post exposure
prophylaxis for HIV ?

3. Exposure

OCCUPATIONAL EXPOSURE that may
place a worker at risk of HIV infection is a
percutaneous injury ,contact of mucous
membrane or contact of skin (especially when
the skin is chapped, abraded or affected with
dermatitis or the contact is prolonged or
involves an extensive area ) with blood tissue or
other body fluids to which universal precautions
apply.
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4. Why this helpline ?

5. Why this helpline ?



The needle stick injury can not only lead to some life
threatening blood borne infections as well as have
severe emotional impact on health care personnel.
It is an medical emergency and can happen anywhere
anytime
FOGSI initiative is first of its kind in world
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6. What is the extent of the problem ?

Survey of 428 HCW in India
- 343 (80%) had 1 PI in past 1
year (IJMR, April,2010)

In USA there are 57 documented
cases of health care workers
contracting
HIV
from
exposures; 137 other possible
cases
(NEJM 2003;348:826)
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8. Rationale of PEP
Information about primary HIV infection
indicate that systemic infection does not occur
immediately leaving a brief period within ‘window
of opportunity’ during which post exposure antiretroviral intervention may modify viral replicaiton
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9. Principle behind administering PEP
Surface ligands of
dendritic cells of skin
or mucous membrane
CD4 CELL
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10. WHAT TO DO ON EXPOSURE

It is a medical emergency

Do not panic
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11. WHAT NEXT

REPORT PROMPTLY

PEP MUST START AT THE EARLIEST
PREFERABLY WITHIN TWO HOURS
 MAY BE UPTO 72 HOURS

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12. How to assess risk ?
The exposure report
(Each exposure is unique)
•





Date and time of exposure
Accurate report: Minute to minute details are ideal
Procedure details…what, where, how, with what
device
Exposure details...route, body substance involved,
volume/duration of contact
Information about source person and exposed
person
Exposure management details
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13. Launch of HELPLINE
International Conference of HIV and Women
16 November, 2008, Nagpur

15. How does HELPLINE work ?

16. How helpline works






A call is received from an exposed health care
worker by Dr Alok Vashishtha, Specialist in
HIV/AIDS on his cell. He then follows
following procedure:
Details of exposure are taken
A protocol is decided
ARV drugs are made available (if required)
Follow up is done as decided
Have a team of resource persons for complex
scenarios

17. How drugs are made available




Have a memorandum of understanding with all
companies making and marketing HIV drugs.
Dr Alok Vashishtha have the mobile numbers of
National Sales manager of all companies in field
of HIV therapy.
Their pan India sales network of about 2500
executives is used to locate the pharmacy
catering these drugs.
Address is given to the exposed health care
provider

19. Type of calls






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Call from around all states of India
Call from Asia, Africa, Europe and USA.
Problem phone calls (General query about
HIV/AIDS)
Special kind of exposures
Missed calls
Stigma calls
For locating a OBGYN

20. Conclusions






Health care workers put themselves at risk in their work
Prevention of exposures is critical
PEP can be useful intervention
Management of occupational exposure is complex
Expert consultation should be sought
Finally
Awareness of Universal precautions and PEP options:
- allay fears of caring for HIV infected persons
- reduced stigma and discrimination
- better care of PLHIV
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21. HELP LINE TEAM
Dr. Narendra Malhotra
 Dr. C.N. Purandare
 Dr. Laxmi Shrikhande
 Dr .Alok Vashistha
ACKNOWLEDGEMENTS
 All FOGSI Members

www.fogsi.org

22. Prevention is better than cure
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23. Thank You for your kind attention
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Nirmal Medical Foundation, Hardwar
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