The HIV epidemic in the country has been described as low prevalence. There were 7, 490 people estimated to be living with HIV in 2007, out of an adult population of 44, 608, 300 (15 to 49 years old), with an HIV prevalence rate of 0.017%. HIv in the Philippines is predominantly sexually transmitted (85%).
Prospective studies worldwide indicate the average risk of HIV infection after a single percutaneous exposure to HIV-infected blood is 0.3% (range: 0.2% to 0.5%). After an exposure of mucous membranes in the eye, nose or mouth, the risk is approximately 0.1%. The precise risk of transmission after skin exposure remains unknown but is believed to be even smaller than that for mucous membrane exposure.
In a restropective case-control study of HCP, an increased risk for HIV infection was associated with exposure to a relatively large volume of blood, as indicated by a deep injury with a device that was visibly contaminated with the patient's blood, or a procedure that involved a needle placed in a vein or artery. The risk was also increased if the exposure was to blood from patients with terminal illnesses, possibly reflecting the higher titer of HIV in late-stage AIDS.
Recommendations
1. Offer the HBV vaccination series to all DHCP with potential occupational exposure to blood or other potentially infectious material.
2. Always follow Department of Health recommendation for hepatitis B vaccination, serologic testing, follow-up and booster dosing 3. Test DHCP for anti HBs 1 to 2 months after completion of the 3 dose vaccination series.
3. DHCP should complete a second 3-dose vaccine series or be evaluated to determine if they are HBsAG-positive if no antibody response occurs to the primary vacine series.
4. Retest for anti-HBs at the completion of the second vacine series. If no response to the second 3-dose series occurs, nonresponders should be tested for HBsAg.
5. Counsel nonresponders to vaccination who are HBsAg-negativeregarding their susceptibility to HBV infection and precautions to take.
6. Provide employees appropriate education regarding the risks of HBV transmission and the availability of the vaccine. Employees who decline the vaccination shuold sign a declination from to be kept on file with the employee.