Health care workers are often exposed through occupational accidents to HIV or hepatitis and other blood borne diseases. Studies have found that prompt treatment for exposures can help reduce the number of persons who actually become infected from these accidents.

Now a new 24-hour emergency hotline for clinicians who need advice on treating patients who have suffered occupational exposures to blood has opened to help provide prompt and appropriate treatment. The free hotline is open seven days a week by calling 888-HIV-4911 (888-448-4911).

The hotline, called the National Clinician's Post-Exposure Prophylaxis Hotline (PEPLine), is staffed by UCSF health care providers at San Francisco General Hospital. PEPLine offers the most current information on treatment for occupational exposures. Callers to PEPLine will receive immediate advice from physicians, clinical pharmacists or nurse practitioners. Non-emergency calls will be returned during business hours.

The PEPLine experts will help callers assess patient risk, discuss the current post-exposure prophylaxis protocols, and review specific treatment and follow-up options. Written materials expanding on the telephone discussion will be sent when needed. Protocols are also available on the internet (http://epi-center.ucsf.edu).

"Recent studies suggest that prompt treatment can be critically important for many health care workers sustaining occupational exposures,” says Julie L. Gerberding, MD, MPH, co-director of the PEPLine. “Antiretroviral therapy is potentially a life-saver. However, therapy should be started as soon as possible after an exposure. That's why the PEPLine can make a difference." Gerberding is a UCSF associate professor of medicine and director of the UCSF/SFGH Epidemiology and Prevention Interventions (EPI) Center.

The PEPLine was created by combining resources from two existing UCSF programs--the National HIV Telephone Consultation Service (Warmline) and the Needlestick Hotline. The Warmline (800-933-3413) is a free consultation service for health care providers caring for HIV-infected patients and is supported by the Health Resources and Services Administration (HRSA). The Needlestick Hotline was developed by Gerberding in 1988 to provide immediate treatment to exposed health care workers at SFGH and has served as a model for similar programs.

"Over the past four years, the Warmline has received more than 900 calls about needlesticks and other occupational exposures, and the number of calls is increasing," said Ronald H. Goldschmidt, MD, director of the Warmline, co-director of the PEPLine and UCSF professor of family and community medicine. "Health care workers are justifiably concerned about this issue and they need the most current information."

The development of new antiretroviral drugs has given hope to HIV-infected persons and to exposed health care workers. However, these advances also mean that determining the most effective prophylaxis regimens can be difficult, Goldschmidt said. Those responsible for providing help to exposed health care workers are not uniformly knowledgeable about assessing risk and selecting the most appropriate interventions, he pointed out. The PEPLine will ensure that state-of-the-art knowledge is available to all health care workers who suffer occupational exposures.

PEPLine is a joint service of the UCSF Community Provider AIDS Training Project, the UCSF Department of Family and Community Medicine, the EPI-Center, the UCSF Department of Medicine at SFGH, and the San Francisco Department of Public Health. PEPLine is funded by HRSA and the Centers for Disease Control, in collaboration with the San Francisco Department of Health and UCSF.

By Alice Trinkl

1st appeared 11/17/97

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