Diferencia entre revisiones de «HIV post-exposure prophylaxis»

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==Background==
==Background==
*~79% transmission reduction
*Initiate ASAP (goal = 1-2 hours)
*>36 hours: normally deferred, unless particularly high risk
*Common side-effects = constitutional, gastrointestinal


===Exposure Transmission Risk===
===Exposure Transmission Risk===
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^assumes no condom use
^assumes no condom use


==Workup==
===High Risk Exposures===
#Td
'''Source'''
#Hepatitis B PEP for non-vaccinated
#Symptomatic HIV/AIDS
##Hepatitis B immunoglobulin and/or vaccine
#Acute seroconversion
#Source labs
#High viral load
##Rapid HIV, hep pannel, RPR?
#Exposed labs
##Rapid HIV, hep pannel, RPR?
#Consider HIV PEP
##CBC, C7, LFTs, Icon if considering HIV PEP


^Currently no PEP for Hep C
'''Exposure'''
#Deep injuries
#Visible blood on device
#Injuries sustained placing a catheter in a vein/artery


==HIV PEP==
==Workup (Before Giving)==
*~79% transmission reduction
*CBC
*Initiate ASAP (goal = 1-2 hours)
*C7
*>36 hours: normally deferred, unless particularly high risk
*LFTs
*Common side-effects = constitutional, gastrointestinal
*Pregnancy test


=== Specific Regimens (CDC) ===
==Regimens (CDC)==
#Basic (2-Drug)
#Basic (2-Drug)
##Tenofovir-Emtricitabine 300mg/200mg (Truvada): 1 tab PO QD
##Tenofovir-Emtricitabine 300mg/200mg (Truvada): 1 tab PO QD
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National HIV/AIDS Clinicians' Consultation Center: 888-448-4911
National HIV/AIDS Clinicians' Consultation Center: 888-448-4911
==High Risk==
'''Source'''
#Symptomatic HIV/AIDS
#Acute seroconversion
#High viral load
'''Exposure'''
#Deep injuries
#Visible blood on device
#Injuries sustained placing a catheter in a vein/artery


==See Also==
==See Also==
[[Occupational Exposure]]
*[[Occupational exposure]]
*[[Sexual assault]]


==Source==
==Source==
8/07 DONALDSON


[[Category:ID]]
[[Category:ID]]

Revisión del 04:14 15 ene 2015

Background

  • ~79% transmission reduction
  • Initiate ASAP (goal = 1-2 hours)
  • >36 hours: normally deferred, unless particularly high risk
  • Common side-effects = constitutional, gastrointestinal

Exposure Transmission Risk

Exposure^
 Risk
Percutaneous 0.3%
Mucocutaneous 0.09%
Needle-sharing injection drug 0.7%
Receptive anal intercourse 0.5%
Receptive penile-vaginal intercourse 0.1%
Insertive anal intercourse 0.07%
Insertive penile-vaginal intercourse 0.05%
Receptive oral (male) intercourse 0.01%
Insertive oral (male) intercourse 0.005%

^assumes no condom use

High Risk Exposures

Source

  1. Symptomatic HIV/AIDS
  2. Acute seroconversion
  3. High viral load

Exposure

  1. Deep injuries
  2. Visible blood on device
  3. Injuries sustained placing a catheter in a vein/artery

Workup (Before Giving)

  • CBC
  • C7
  • LFTs
  • Pregnancy test

Regimens (CDC)

  1. Basic (2-Drug)
    1. Tenofovir-Emtricitabine 300mg/200mg (Truvada): 1 tab PO QD
    2. OR, Zidovudine-Lamivudine 300mg/150mg (Combivir)^: 1 tab PO BID
  2. Expanded (3-Drug)
    1. Ritonavir-Lopinavir 50mg/200mg(Kaletra): 2 tabs PO BID
      1. PLUS tenofovir-emtricitabine OR zidovudine-lamivudine

^Prefered in pregnancy

National HIV/AIDS Clinicians' Consultation Center: 888-448-4911

See Also

Source

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