Abstract
The Centers for Disease Control and Prevention, national public health agencies, and an expert committee of the European Commission have recently published updated guidelines on postexposure prophylaxis (PEP) of occupational human immunodeficiency virus (HIV) exposure. 1,2 Management of occupational HIV exposure relies heavily on HIV antibody testing of the source patient. However, patients with acute HIV infection may be antibody negative yet particularly contagious because of high viremia. We report 2 cases involving health care workers who were exposed to patients with acute primary HIV infection (PHI). The patients were in the window period of seroconversion, during which detection of HIV p24 antigen provided the definitive indication for PEP. We also review the literature on the topic.
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