HIV post-exposure prophylaxis

1) Td

2) Hepatitis B PEP for non-vaccinated

    -Hepatitis B immunoglobulin and/or vaccine

3) Source labs

    -Rapid HIV, hep pannel, RPR?

4) Exposed labs

    -Rapid HIV, hep pannel, RPR?

5) Consider HIV PEP

    -CBC, C7, LFTs, Icon if considering HIV PEP

HIV PEP

~79% transmission reduction

Initiate ASAP (goal = 1-2 hours)

>36 hours: normally deferred, unless particularly high risk

Common side-effects = constitutional, gastrointestinal

CDC website lists specific regimens

1) Basic

-Exposures for which there is a recognized transmission risk

-4 week, 2 drug regimen (normally zidovudine and lamivudine)

2) Expanded

-High risk exposures

-Basic regimen + protease inhibitor (e.g. indinavir or nelfinavir)

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

8/07 DONALDSON

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