HIV, needlestick: free information for dental workers.

Hotlines and a website help with questions and concerns on exposure to HIV and needlesticks with information offered by the National HIV/AIDS Clinicians' Consultation Center (NCCC).

On the web: The NCCC is an AIDS Education and Training Center clinical resource for health care professionals, from the University of California, San Francisco, at San Francisco General Hospital. Some of the items you will find when visiting the web site include:

* Updated Compendium of State HIV Testing Laws

* Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health Care Settings

To visit this website go to www.ucsf.edu/hivcntr

For one-to-one responses, however, a variety of hotlines are available. This hotline service was established 15 years ago and has logged almost 100,000 calls, but relatively few of them (less than 5 percent) are from dental professionals--assistants and hygienists call more than dentists. The hotlines help the dental professional to be in touch with an expert at once when making triage decisions, dealing with occupational exposure and providing information on local resources throughout the country.

* The National HIV/AIDS Telephone Consultation Service (Warmline)

The Warmline provides expert clinical advice on HIV/AIDS management for health care providers, from those with limited access to expert consultation to those with complex antiretroviral resistance dilemmas. The Warmline is available Monday through Friday, 8 a.m. to 8 p.m. EST. Call: 1-800-933-3413.

* The National Clinicians' Post-Exposure Prophylaxis Hotline (PEPline)

The PEPline provides around-the-clock expert guidance in managing health care worker exposures to HIV and Hepatitis B and C. Callers receive immediate post-exposure prophylaxis recommendations. Call 1-888-448-4911.

* The National Perinatal HIV Consultation and Referral Service (Perinatal Hotline)

The Perinatal Hotline provides around-the-clock advice on indications and interpretations of standard and rapid HIV testing in pregnancy as well as consultation on antiretroviral use in pregnancy, labor and delivery, and the postpartum period. The Perinatal HIV Consultation and Referral Service also links HIV-infected pregnant women with appropriate health care. Call: 1-888-448-8765.

According to an article published in ADA News last year, Dr. Ron Goldschmidt, M.D., cofounder of the NCCC, advised that these are some of the questions dental clinicians should consider if they think they have been exposed to HIV:

Was this an exposure of importance? Dr. Goldschmidt says, "Most of the hollow-bore needles in dentistry are very tiny and used more for injection. They seem to be less likely to be prone to passing infection than the larger bore needles used to draw blood or provide IV. Nevertheless, all needles and other instruments that can similarly puncture the skin can be a source of transmission."

Does the Source Patient have HIV? How do you find out? Most dental practices aren't set up to evaluate a patient's HIV status. A PEPline consultant may suggest that a health care worker visit a hospital emergency room if they are concerned about HIV. Depending on legal constrictions, the emergency room personnel can often follow-up with Source Patients to determine HIV status.

Is prophylaxis with antiretroviral drug called for? If so, what drugs and for how long? PEPline consultants may advise where to find proper treatment.

Other resources for AIDS and needlestick information:

* The AIDS Education and Training Center National Resource Center at ww.ucsf.edu/hivcntr/index.html

* The Centers for Disease Control and Prevention at www.cdc.gov

* The American Dental Association (ADA regulatory Compliance Manual) www.ada.org