A nurse sustains a deep stick from a bloody needle used to start intravenous fluids 2 hours ago on a patient admitted for sepsis. The source patient's HIV status is unknown. Rapid testing is not available and the results are expected back in 3 days. The source patient's past medical history is significant for hepatitis C and IV drug use in the past month. The most appropriate way to manage this exposure is:
A) Start the exposed nurse on three-drug PEP today. Continue the PEP regimen for 28 days regardless of the results of the source person's HIV test.
B) Start the exposed on two-drug PEP today. Add a third antiretroviral (ARV) if the source patient is determined HIV positive.
C) Start the exposed on three-drug PEP today. Discontinue PEP if the source patient's HIV RNA result is negative.
D) Start the exposed on three-drug PEP today. Discontinue PEP if the source patient's HIV antibody test result is negative.
Correct Answer:
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