He had immediate testing for hiv using a fourth generation antibodyantigen assay as recommended 12, hepatitis b and c serologies, syphilis. The guideline offers recommendations on how to assess risk following a potential exposure to hiv, and how and when to prescribe post exposure prophylaxis medication. Prep and pep consumer education materials online order form. Postexposure prophylaxis pep is the administration of antiretro viral therapy art to hivnegative people who may have been occupationally or sexually exposed to hiv. Post exposure prophylaxis pep naco guidelines post. The guideline is for use in locations within the mersey, cheshire, and north wales hiv managed care network. Individuals who have been prescribed postexposure prophylaxis pep. Federal and bestpractice recommendations for post exposure prophylaxis pep decisions. A regimen for postexposure prophylaxis for hiv with two arv drugs is effective, but three drugs are preferred. Pep for sexual assault payment options for adolescents and adults march 2018 pdf payment options for adolescents and adults for postexposure prophylaxis for all other nonoccupational exposures march 2018 pdf medication information. The california state board of pharmacy board is proposing an emergency action to add a regulation related to the independent initiation and furnishing of hiv preexposure prophylaxis prep and hiv postexposure prophylaxis peprecommended by the federal centers for. You must start it within 72 hours after you were exposed to hiv, or it wont work. Apr 17, 2020 shortterm treatment started as soon as possible after highrisk occupational exposure to an infectious agent, such as hiv, hepatitis b virus hbv, or hepatitis c virus hcv.
Pep must be started within 72 hours 3 days after a possible exposure to hiv. Emtricitabine, hiv, postexposure prophylaxis following potential sexual. Exposures that occurred 72 hours or less to beginning treatment are eligible for postexposure prophylaxis. It involves taking hiv medications as soon as possible after a potential exposure to. Luke s roosevelt hospital a free powerpoint ppt presentation displayed as a flash slide show on id. Care after sexual assault beyond the basics abacavir hypersensitivity reaction. Current guidelines for postexposure prophylaxis pep are almost exclusively generated in the developed world, where hiv is far less prevalent than in the southern african region. Change to recommended regimen for postexposure prophylaxis pep. Peract risk of hiv art for pep after exposure to hiv nonoccupational hiv exposure labs postexposure prophylaxis to hbv after nonoccupational exposure hbv vaccine doses for us adults, by age and vaccine type related topics. The use of cotrimoxazole prophylaxis for hivrelated infections among adults. Hiv prep pre exposure prophylaxis updated march 2019. Independent hiv preexposure and postexposure prophylaxis furnishing. If you require further copies of this title quote 289897hiv postexposure.
The timing of exposure does not affect the risk of developing hiv, but it does alter whether post exposure prophylaxis will be recommended. Twenty six hours previously, he had anal receptive intercourse without a condom with a man of unknown hiv serostatus. Interim statement regarding potential fetal harm from exposure. Preexposure prophylaxis is an emerging hivprevention strategy for msm and potentially other populations at risk for hiv acquisition. Post exposure prophylaxis for hiv and hbv may reduce the risk of transmission if administered soon after the exposure. S, the cdc, and current literature provide information on identifying, managing, and following up on potential exposures to hiv and hepatitis b and c.
An adolescent is a person aged 10 to 19 years inclusive. Occupational postexposure prophylaxis opep definition. Nonoccupational hiv post exposure prophylaxis npep robert harrington, m. Pep 101 consumer info sheet english and spanish pdf icon pdf 691 kb resources for providers. Hiv nonoccupational postexposure prophylaxis npep is a preventive treatment strategy that may reduce, but not eliminate, the possibility of becoming infected with hiv among individuals who have experienced highrisk exposures such as. Post exposure prophylaxis, or pep, is a way to help prevent the transmission of hiv in an hiv negative person who may have been recently exposed to the virus.
Read the 30 days to slow the spread guidance pdf, 680 kb. The national hiv curriculum is an aids education and training center aetc program supported by the health resources and services administration hrsa of the u. Please see attached statement pdf of dolutegravir attached. Guidelines for post exposure prophylaxis pep for hiv. Pep is the use of antiretroviral drugs after a single highrisk event to stop hiv seroconversion. Guidance from the uk chief medical officers expert advisory group on aids, dept of health, 2008. The incidence of human immunodeficiency virus hiv infection continues to rise among core groups and efforts to reduce the numbers of new infections are being redoubled.
Post exposure prophylaxis and prophylactic treatment for. Was the source patient hiv, meningitis, anthrax status negative. It is extremely unlikely that this will change, as randomised studies of different drug regimens for pep are not feasible owing to the complexity of exposure, low event rate, and inability to ethically have a placebo group. Postexposure prophylaxis pep involves taking hiv medicines very soon after a possible exposure to hiv to prevent becoming infected with hiv. Updated guidelines for antiretroviral postexposure. Postexposure prophylaxis pep hiv risk and prevention. Postexposure prophylaxis pep understanding hivaids. Learn about who pep is for, when you should take it. To realize an individual and public health benefit, prep must make its way from the research arena into clinical and community settings. Access to the 2009 protocol is being temporarily provided while the health regions transition to the new process. Interim statement regarding potential fetal harm from exposure to dolutegravir implications for hiv postexposure prophylaxis pep. Background the preferred regimen for hiv postexposure prophylaxis pep is based mainly on safety and tolerability because it is given to immunocompetent people without hiv infection for a. However, in these guidelines when a person falls into the 10 to 19 age category they are referred to as an adolescent see adolescent definition.
Postexposure hiv prophylaxis symptoms, diagnosis and. Occupational postexposure prophylaxis question bank. Pep must be started as soon as possible to be effectiveand always within 72 hours of a possible exposure. Postexposure prophylaxis for hiv, hbv and hcv 1 integrated protocol for managing exposures to blood and body fluids in manitoba quick pep guide figure 1 diagram of initial, nonspecific portion of the pep algorithm p e p a l g a o r i t h m v i n i t i a l n o n s p e c i f go to e of i c initiate nonspecific prophylaxis sec. The purpose of occupational postexposure prophylaxis opep is to. George washington university senior technical advisor. Risk of transmission, timing of postexposure prophylaxis pep, preferred regimen, drugdrug interactions, followup. Pep, or postexposure prophylaxis, is a short course of hiv medicines taken very soon after a possible exposure to hiv to prevent the virus from taking hold in your body. Postexposure prophylaxis pep means taking hiv medicines very soon after a possible exposure to hiv to prevent becoming infected with hiv. A regimen for post exposure prophylaxis for hiv with two arv drugs is effective, but three drugs are preferred.
Consideration of other alternative hiv npep antiretroviral regimens. May 10, 2019 post exposure prophylaxis pep means taking hiv medicines very soon after a possible exposure to hiv to prevent becoming infected with hiv. Occupational postexposure prophylaxis national hiv curriculum. A child is a person 19 years or younger unless national law defines a person to be an adult at an earlier age. For people who need to prevent hiv after a single highrisk potential hiv exposure, such as condomless anal sex or a sexual assault, there is another option, post exposure prophylaxis, or pep. Pep means taking medicines after you may have been exposed to hiv to. See exposure control program for additional direction. An example of a highrisk occupational exposure is exposure to an infectious agent as the result of a needlestick injury in a health care setting. Jul 17, 2017 post exposure prophylaxis pep is the administration of antiretro viral therapy art to hiv negative people who may have been occupationally or sexually exposed to hiv. The timing of exposure does not affect the risk of developing hiv, but it does alter whether postexposure prophylaxis will be recommended. In 1990, the centers for disease control and prevention cdc issued a statement that management of occupational exposure to hiv should consider use of. Several corrections have been made to this pdf since online publication of the updated us public health service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis in infection control and hospital epidemiology on august 6, 20 iche 20.
Post exposure prophylaxis, or pep, is a course of two or three drugs that will lower your chance of infection if youve been exposed to hiv. Once exposed to hiv, there may be a brief period before the infection is established, during which art may successfully prevent viral replication. Post exposure prophylaxis pep is a short course of hiv medicines antiretroviral drugs taken very soon for people who are hiv negative after a possible highrisk exposure to hiv to prevent the virus from taking hold in your body. Background the preferred regimen for hiv post exposure prophylaxis pep is based mainly on safety and tolerability because it is given to immunocompetent people without hiv infection for a. Pep or post exposure prophylaxis involves taking antihiv drugs very soon. Current perspectives in hiv postexposure prophylaxis. Updated guidelines to the 2005 dhhs npep guidelines providing recommendations on the use of antiretroviral npep and other aspects of case management for persons exposed to hiv outside of occupational settings. Recommendations following nonoccupational exposure have been updated, and information about pep in the context of preexposure prophylaxis prep, pep and children, renal disease, and gender identity and history has been added. Associate medical director center for comprehensive care, west village division st. It is not meant for regular use by people who may be exposed to hiv frequently. The use of occupational pep opep for case management for persons with possible hiv exposures occurring in health care settings are not addressed in this. The term post exposure prophylaxis is generally understood to mean the medical response given to prevent the transmission of bloodborne pathogens following a potential exposure to hiv. Occupational exposure management sample flow chart.
Jun 04, 2018 post exposure prophylaxis pep involves taking hiv medicines very soon after a possible exposure to hiv to prevent becoming infected with hiv. Was exposure on intact skin only or droplet exposure with precautions were in place and maintained. Uk guideline for the use of hiv postexposure prophylaxis. Hiv prep preexposure prophylaxis updated march 2019.
Federal and bestpractice recommendations for postexposure prophylaxis pep decisions. Postexposure prophylaxis is the practice of providing treatment immediately after a suspected or confirmed biological agent release in order to attempt to limit the duration, severity, incidence and transmission of subsequent disease in asymptomatic individuals. Guidelines on postexposure prophylaxis for hiv and the use of co. Jun 26, 2019 pep, or postexposure prophylaxis, is a short course of hiv medicines taken very soon after a possible exposure to hiv to prevent the virus from taking hold in your body.
Postexposure prophylaxis an overview sciencedirect topics. Change to recommended regimen for post exposure prophylaxis pep. Oct 24, 2014 the incidence of human immunodeficiency virus hiv infection continues to rise among core groups and efforts to reduce the numbers of new infections are being redoubled. It involves taking hiv medications as soon as possible after a potential exposure to hiv. Integrated protocol for managing exposures to blood and body fluids in manitoba. Postexposure prophylaxis pep is the administration of antiretroviral therapy art to hivnegative people who may have been occupationally or sexually exposed to hiv. The decision to prescribe pep is based on the risk of hiv. Exposures that occurred 72 hours or less to beginning treatment are eligible for post exposure prophylaxis. Emergency postexposure prophylaxis can prevent hiv infection please share this alert with colleagues in emergency medicine, primary care, hiv care, internal medicine, family medicine, pediatrics, adolescent medicine, and with frontline staff in your facility. Postexposure prophylaxis, or pep, is a course of two or three drugs that will lower your chance of infection if youve been exposed to hiv. For people who need to prevent hiv after a single highrisk potential hiv exposure, such as condomless anal sex or a sexual assault, there is another option, postexposure prophylaxis, or pep.
Click on any of the sections in the following table of contents, and the corresponding page of the pdf version of the protocol will open in a new. Nov 29, 2018 hiv post exposure prophylaxis pep is a safe and effective treatment strategy aimed at preventing infection in those with a recent hiv exposure pep is typically prescribed as three hiv antiretroviral drugs started within 72 hours after exposure, and continued for 28 days. Individuals who have been prescribed post exposure prophylaxis pep. This includes both sexual and occupational exposures. Post exposure prophylaxis pep naco guidelines post exposure prophylaxis pep refers to the comprehensive management given to minimize the risk of infection following potential exposure to bloodborne pathogens hiv, hbv, hcy. Hiv postexposure prophylaxis guidance from the uk chief medical officers expert advisory group on aids 289897 1p 4k sep 08 col produced by coi for the department of health if you require further copies of this title visit. Ppt postexposure prophylaxis powerpoint presentation. Shortterm treatment started as soon as possible after highrisk occupational exposure to an infectious agent, such as hiv, hepatitis b virus hbv, or hepatitis c virus hcv. Visit the nonoccupational postexposure prophylaxis npep toolkit from the aetc national coordinating resource center external icon. Updated guidelines for antiretroviral postexposure prophylaxis after sexual, injection drug use, or other nonoccupational exposure to hiv united states, 2016 from the centers for disease control and prevention, u. Postexposure prophylaxis, or pep, is a way to help prevent the transmission of hiv in an hivnegative person who may have been recently exposed to the virus. Recommendations following nonoccupational exposure have been updated, and information about pep in the context of pre exposure prophylaxis prep, pep and children, renal disease, and gender identity and history has been added. Pre exposure prophylaxis is an emerging hiv prevention strategy for msm and potentially other populations at risk for hiv acquisition. Further supporting documents are also available via the new guidelines website at.
Postexposure prophylaxis pep following potential sexual exposure is an important. Anyone who thinks they may have been exposed to hiv should contact. Visit the prescribe hiv prevention website to learn about using prep and pep to reduce new hiv infections. Northwest aids education and training center postexposure prophylaxis hiv and hbv christian b. Postexposure prophylaxis pep is a short course of hiv medicines antiretroviral drugs taken very soon for people who are hivnegative after a possible highrisk exposure to hiv to prevent the virus from taking hold in your body. Pdf current perspectives in hiv postexposure prophylaxis. Postexposure prophylaxis pep catie canadas source for. Although exposure prevention remains the primary strategy for reducing occupationally acquired hiv infection, appropriate postexposure management is an important element of workplace safety.
Postexposure prophylaxis pep for hiv there is not sufficient evidence about the effect of these medications during pregnancy so pregnant women may still be advised to take them if the benefits are greater than the possible risks. Daily emtricitabinetenofovir df truvada is safe and effective for significantly reducing the risk of hiv infection in sexually active individuals including adolescents and people who inject drugs pwid when used consistently. Updated guidelines for antiretroviral postexposure prophylaxis after. Postexposure prophylaxis pep is the use of shortterm antiretroviral therapy art to reduce the risk of acquisition of hiv infection following exposure. Management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis infect control and hosp epidemiology 20.
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