HIV post-exposure prophylaxis - Revision history

Rossdonaldson1 at 21:05, 7 June 2022

2022-06-07T21:05:34Z

← Older revision		Revision as of 21:05, 7 June 2022
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	==Management==		==Management==
	*Refer to the PDF below for Harbor Specific Management
	** https://wikem.org/wiki/File:Non-occupational_Post-Exposure_Prophylaxis_(nPEP)_for_HIV_Prevention_in_Adults_and_Adolescents_Expected_Practice.pdf
	===Negligible Risk===		===Negligible Risk===
	*NOT recommended		*NOT recommended
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	==External Links==		==External Links==
			*Harbor-UCLA Policy: https://wikem.org/wiki/File:Non-occupational_Post-Exposure_Prophylaxis_(nPEP)_for_HIV_Prevention_in_Adults_and_Adolescents_Expected_Practice.pdf
	*http://ph.lacounty.gov/dhsp/prep-pep-actionkit.htm		*http://ph.lacounty.gov/dhsp/prep-pep-actionkit.htm
	*[https://www.cdc.gov/hiv/risk/pep/index.html CDC: Post-Exposure Prophylaxis]		*[https://www.cdc.gov/hiv/risk/pep/index.html CDC: Post-Exposure Prophylaxis]

Mtjordan91: /* CDC recommendations */

2021-12-14T22:36:51Z

CDC recommendations

← Older revision		Revision as of 22:36, 14 December 2021
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	From 2013 recommendations <ref>Kuhar DT et al. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013 Sep;34(9):875-92. doi: 10.1086/672271.</ref>		From 2013 recommendations <ref>Kuhar DT et al. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013 Sep;34(9):875-92. doi: 10.1086/672271.</ref>
	*PEP is recommended when occupational exposures to HIV occur		*PEP is recommended when occupational exposures to HIV occur
	*PEP medication regimens should be started as soon as possible after occupational exposure to HIV, and continued for ~~a 4-week duration~~		*PEP medication regimens should be started as soon as possible after occupational exposure to HIV, and continued for 28 days
	*'''New recommendation''' - PEP medication regimens should contain 3 (or more) antiretroviral drugs for all occupational exposures to HIV		*'''New recommendation''' - PEP medication regimens should contain 3 (or more) antiretroviral drugs for all occupational exposures to HIV
	*'''New recommendation''' - if a newer fourth-generation combination HIV p24 antigen-HIV antibody test is utilized for follow-up HIV testing of exposed HCP, HIV testing may be concluded 4 months after exposure; if a newer testing platform is not available, follow-up HIV testing is typically concluded 6 months after an HIV exposure.		*'''New recommendation''' - if a newer fourth-generation combination HIV p24 antigen-HIV antibody test is utilized for follow-up HIV testing of exposed HCP, HIV testing may be concluded 4 months after exposure; if a newer testing platform is not available, follow-up HIV testing is typically concluded 6 months after an HIV exposure.

Mtjordan91: /* Timing and Duration of PEPKuhar DT et al. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013...

2021-12-14T22:33:13Z

/* Timing and Duration of PEPKuhar DT et al. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013...

← Older revision		Revision as of 22:33, 14 December 2021
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	===Timing and Duration of PEP<ref>Kuhar DT et al. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013 Sep;34(9):875-92. doi: 10.1086/672271.</ref>===		===Timing and Duration of PEP<ref>Kuhar DT et al. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013 Sep;34(9):875-92. doi: 10.1086/672271.</ref>===
	*Initiate ASAP (goal = <2 hours after exposure)		*Initiate ASAP (goal = <2 hours after exposure)
	*~~>36~~ hours~~: normally deferred, unless particularly high risk~~		*Initiate if <72 hours since exposure
	*PEP is likely to be less effective when started more than 72 hours after exposure, but the interval after which no benefit is gained from PEP for humans is undefined.		*PEP is likely to be less effective when started more than 72 hours after exposure, but the interval after which no benefit is gained from PEP for humans is undefined.
	*If initiation is delayed, the likelihood increases that benefits might not outweigh the risks inherent in taking antiretroviral medications.		*If initiation is delayed, the likelihood increases that benefits might not outweigh the risks inherent in taking antiretroviral medications.
	*Initiating therapy after a longer interval (eg, 1 week) might still be considered for exposures that represent an extremely high risk of transmission

	===CDC recommendations===		===CDC recommendations===

Mtjordan91: /* External Links */

2021-12-14T22:30:50Z

External Links

← Older revision		Revision as of 22:30, 14 December 2021
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	*http://ph.lacounty.gov/dhsp/prep-pep-actionkit.htm		*http://ph.lacounty.gov/dhsp/prep-pep-actionkit.htm
	*[https://www.cdc.gov/hiv/risk/pep/index.html CDC: Post-Exposure Prophylaxis]		*[https://www.cdc.gov/hiv/risk/pep/index.html CDC: Post-Exposure Prophylaxis]
			*http://getprepla.com/

	==References==		==References==

Mtjordan91: /* See Also */

2021-12-14T22:30:32Z

Mtjordan91: /* See Also */

2021-12-14T22:30:06Z

Mtjordan91: /* Management */

2021-12-14T22:28:17Z

Management

← Older revision		Revision as of 22:28, 14 December 2021
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	==Management==		==Management==
			*Refer to the PDF below for Harbor Specific Management
			** https://wikem.org/wiki/File:Non-occupational_Post-Exposure_Prophylaxis_(nPEP)_for_HIV_Prevention_in_Adults_and_Adolescents_Expected_Practice.pdf
	===Negligible Risk===		===Negligible Risk===
	*NOT recommended		*NOT recommended

Elcatracho: /* External Links */

2021-02-01T21:17:13Z

External Links

← Older revision		Revision as of 21:17, 1 February 2021
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	==External Links==		==External Links==
	http://ph.lacounty.gov/dhsp/prep-pep-actionkit.htm		*http://ph.lacounty.gov/dhsp/prep-pep-actionkit.htm
			*[https://www.cdc.gov/hiv/risk/pep/index.html CDC: Post-Exposure Prophylaxis]

	==References==		==References==

Alvarez13 at 03:56, 1 December 2018

2018-12-01T03:56:47Z

Rossdonaldson1: /* Background */

2017-11-19T23:00:29Z

Background

← Older revision		Revision as of 23:00, 19 November 2017
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	==Background==		==Background==
			*Also known as HIV Post-Exposure Prophylaxis (PEP)
	*Probability of HIV transmission from a percutaneous needle stick is approximately 0.3% (1 in 300) and 0.09% from mucous membrane exposure.<ref>Marcus R. et al. CDC Cooperative Needlestick Surveillance Group. "Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus". N Engl J Med. 1988. 319: 1118–1123.</ref><ref>Bell D.M. "Occupational risk of human immunodeficiency virus infection in healthcare workers: an overview". Am J Med. 1997. 102: 9–15.</ref>		*Probability of HIV transmission from a percutaneous needle stick is approximately 0.3% (1 in 300) and 0.09% from mucous membrane exposure.<ref>Marcus R. et al. CDC Cooperative Needlestick Surveillance Group. "Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus". N Engl J Med. 1988. 319: 1118–1123.</ref><ref>Bell D.M. "Occupational risk of human immunodeficiency virus infection in healthcare workers: an overview". Am J Med. 1997. 102: 9–15.</ref>
	*Also known as HIV Post-Exposure Prophylaxis (PEP)
	*~79% transmission reduction		*~79% transmission reduction
			*Common side-effects = constitutional, gastrointestinal

			===Timing and Duration of PEP<ref>Kuhar DT et al. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013 Sep;34(9):875-92. doi: 10.1086/672271.</ref>''===
	*Initiate ASAP (goal = <2 hours after exposure)		*Initiate ASAP (goal = <2 hours after exposure)
	*>36 hours: normally deferred, unless particularly high risk		*>36 hours: normally deferred, unless particularly high risk
	*~~Common side-effects = constitutional~~, ~~gastrointestinal~~		*PEP is likely to be less effective when started more than 72 hours after exposure, but the interval after which no benefit is gained from PEP for humans is undefined.
			*If initiation is delayed, the likelihood increases that benefits might not outweigh the risks inherent in taking antiretroviral medications.
			*Initiating therapy after a longer interval (eg, 1 week) might still be considered for exposures that represent an extremely high risk of transmission

	===CDC recommendations===		===CDC recommendations===

← Older revision		Revision as of 22:30, 14 December 2021
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	*[[Harbor:Occupational exposure]]		*[[Harbor:Occupational exposure]]
	**[[Harbor:Occupational exposure (dot-phrases)]]		**[[Harbor:Occupational exposure (dot-phrases)]]
	*http://getprepla.com/

	==External Links==		==External Links==

← Older revision		Revision as of 22:30, 14 December 2021
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	*[[Harbor:Occupational exposure]]		*[[Harbor:Occupational exposure]]
	**[[Harbor:Occupational exposure (dot-phrases)]]		**[[Harbor:Occupational exposure (dot-phrases)]]
			*http://getprepla.com/

	==External Links==		==External Links==

← Older revision		Revision as of 03:56, 1 December 2018
Line 1:		Line 1:
	==Background==		==Background==
	*Also known as HIV Post-Exposure Prophylaxis (PEP)		*Also known as HIV Post-Exposure Prophylaxis (PEP)
	*Probability of HIV transmission from a percutaneous needle stick is approximately 0.3% (1 in 300) and 0.09% from mucous membrane exposure.<ref>Marcus R. et al. CDC Cooperative Needlestick Surveillance Group. "Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus". N Engl J Med. 1988. 319: 1118–1123.</ref><ref>Bell D.M. "Occupational risk of human immunodeficiency virus infection in healthcare workers: an overview". Am J Med. 1997. 102: 9–15.</ref>		*Probability of HIV transmission from a percutaneous needle stick is approximately 0.3% (1 in 300) and 0.09% from mucous membrane exposure.<ref>Marcus R. et al. CDC Cooperative Needlestick Surveillance Group. Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus. N Engl J Med. 1988. 319: 1118–1123.</ref><ref>Bell D.M. Occupational risk of human immunodeficiency virus infection in healthcare workers: an overview. Am J Med. 1997. 102: 9–15.</ref>
	*~79% transmission reduction		*~79% transmission reduction
	*Common side-effects = constitutional, gastrointestinal		*Common side-effects = constitutional, gastrointestinal

	===Timing and Duration of PEP<ref>Kuhar DT et al. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013 Sep;34(9):875-92. doi: 10.1086/672271.</ref>''===		===Timing and Duration of PEP<ref>Kuhar DT et al. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013 Sep;34(9):875-92. doi: 10.1086/672271.</ref>===
	*Initiate ASAP (goal = <2 hours after exposure)		*Initiate ASAP (goal = <2 hours after exposure)
	*>36 hours: normally deferred, unless particularly high risk		*>36 hours: normally deferred, unless particularly high risk
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	===CDC recommendations===		===CDC recommendations===
	''From 2013 recommendations <ref>Kuhar DT et al. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013 Sep;34(9):875-92. doi: 10.1086/672271.</ref>''		From 2013 recommendations <ref>Kuhar DT et al. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013 Sep;34(9):875-92. doi: 10.1086/672271.</ref>
	*PEP is recommended when occupational exposures to HIV occur		*PEP is recommended when occupational exposures to HIV occur
	*PEP medication regimens should be started as soon as possible after occupational exposure to HIV, and continued for a 4-week duration		*PEP medication regimens should be started as soon as possible after occupational exposure to HIV, and continued for a 4-week duration