Template:HIV post-exposure prophylaxis regimens - Revision history

ZKhesbak: /* Preferred HIV PEP RegimenKuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 1...

2022-04-02T00:15:26Z

/* Preferred HIV PEP RegimenKuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 1...

← Older revision		Revision as of 00:15, 2 April 2022
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	*If known source patient with resistant HIV strain, consult HIV service for source-patient-specific PEP		*If known source patient with resistant HIV strain, consult HIV service for source-patient-specific PEP
	*Consider interactions with current medication interactions and contraindications, such as renal impairment with [[Truvada]]		*Consider interactions with current medication interactions and contraindications, such as renal impairment with [[Truvada]]
			**For patients with creatinine clearance <60mL/min, consider [[Raltegravir]] 400mg PO twice daily, '''plus''' [[Zidovudine]] and [[Lamivudine]] with doses adjusted to the degree of renal dysfunction.<ref>Dominguez KL et al. Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV--United States, 2016. Available at: https://stacks.cdc.gov/view/cdc/38856</ref>
	*If the source exposure does report exposure to HIV within the last 6 weeks, HIV RNA PCR (HIV viral load) should be sent along with HIV Ag/Ab screen on the source and nPEP should be initiated for the exposed patient		*If the source exposure does report exposure to HIV within the last 6 weeks, HIV RNA PCR (HIV viral load) should be sent along with HIV Ag/Ab screen on the source and nPEP should be initiated for the exposed patient
	**If both tests result not detected and nonreactive, respectively, nPEP should be discontinued.		**If both tests result not detected and nonreactive, respectively, nPEP should be discontinued.
	**If the source is willing and able to be tested and is found to be HIV-negative with no recent high-risk exposures to HIV, nPEP is not indicated and should not be initiated, or discontinued if already started.		**If the source is willing and able to be tested and is found to be HIV-negative with no recent high-risk exposures to HIV, nPEP is not indicated and should not be initiated, or discontinued if already started.
	**The exposed patient still warrants baseline HIV testing and should be offered baseline and follow-up testing for other transmissible infections, e.g. hepatitis A, B, and C, syphilis, chlamydia, and gonorrhea.		**The exposed patient still warrants baseline HIV testing and should be offered baseline and follow-up testing for other transmissible infections, e.g. hepatitis A, B, and C, syphilis, chlamydia, and gonorrhea.

Mtjordan91: /* Preferred HIV PEP RegimenKuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 1...

2021-12-14T22:46:03Z

← Older revision		Revision as of 22:46, 14 December 2021
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	*If known source patient with resistant HIV strain, consult HIV service for source-patient-specific PEP		*If known source patient with resistant HIV strain, consult HIV service for source-patient-specific PEP
	*Consider interactions with current medication interactions and contraindications, such as renal impairment with [[Truvada]]		*Consider interactions with current medication interactions and contraindications, such as renal impairment with [[Truvada]]
			*If the source exposure does report exposure to HIV within the last 6 weeks, HIV RNA PCR (HIV viral load) should be sent along with HIV Ag/Ab screen on the source and nPEP should be initiated for the exposed patient
			**If both tests result not detected and nonreactive, respectively, nPEP should be discontinued.
			**If the source is willing and able to be tested and is found to be HIV-negative with no recent high-risk exposures to HIV, nPEP is not indicated and should not be initiated, or discontinued if already started.
			**The exposed patient still warrants baseline HIV testing and should be offered baseline and follow-up testing for other transmissible infections, e.g. hepatitis A, B, and C, syphilis, chlamydia, and gonorrhea.

Rossdonaldson1: /* Preferred HIV PEP RegimenKuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 1...

2017-11-19T22:28:16Z

← Older revision		Revision as of 22:28, 19 November 2017
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	====Preferred HIV [[PEP]] Regimen<ref>Kuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 10.1086/672271. http://www.jstor.org/stable/10.1086/672271</ref><ref>Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV—United States, 2016. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services</ref>====		====Preferred HIV [[PEP]] Regimen<ref>Kuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 10.1086/672271. http://www.jstor.org/stable/10.1086/672271</ref><ref>Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV—United States, 2016. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services</ref>====

	''PEP should be started as soon as possible after exposure and continued for 28 days''<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 should be started as soon as possible after significant exposure and continued for 28 days''<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>
	*[[Raltegravir]] (Isentress; RAL) 400 mg PO twice daily, '''plus'''		*[[Raltegravir]] (Isentress; RAL) 400 mg PO twice daily, '''plus'''
	*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)		*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)

Rossdonaldson1: /* Preferred HIV PEP RegimenKuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 1...

2017-11-19T19:51:07Z

← Older revision		Revision as of 19:51, 19 November 2017
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	'''Other Considerations'''		'''Other Considerations'''
	*If known source patient with resistant HIV strain, consult HIV service for source-patient-specific PEP		*If known source patient with resistant HIV strain, consult HIV service for source-patient-specific PEP
	*Consider interactions with current medication interactions and contraindications, such as renal impairment with Truvada		*Consider interactions with current medication interactions and contraindications, such as renal impairment with [[Truvada]]

Rossdonaldson1: /* Preferred HIV PEP RegimenKuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 1...

2017-11-19T19:46:45Z

← Older revision		Revision as of 19:46, 19 November 2017
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	====Preferred HIV [[PEP]] Regimen<ref>Kuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 10.1086/672271. http://www.jstor.org/stable/10.1086/672271</ref><ref>Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV—United States, 2016. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services</ref>====		====Preferred HIV [[PEP]] Regimen<ref>Kuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 10.1086/672271. http://www.jstor.org/stable/10.1086/672271</ref><ref>Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV—United States, 2016. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services</ref>====
	''~~CDC preferred regimen~~ for ~~'''~~28 days''~~' ''~~
			''PEP should be started as soon as possible after exposure and continued for 28 days''<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>
	*[[Raltegravir]] (Isentress; RAL) 400 mg PO twice daily, '''plus'''		*[[Raltegravir]] (Isentress; RAL) 400 mg PO twice daily, '''plus'''
	*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)		*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)

Rossdonaldson1: /* Preferred HIV PEP RegimenKuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 1...

2017-11-19T19:08:09Z

← Older revision		Revision as of 19:08, 19 November 2017
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	===Preferred HIV [[PEP]] Regimen<ref>Kuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 10.1086/672271. http://www.jstor.org/stable/10.1086/672271</ref><ref>Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV—United States, 2016. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services</ref>===		====Preferred HIV [[PEP]] Regimen<ref>Kuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 10.1086/672271. http://www.jstor.org/stable/10.1086/672271</ref><ref>Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV—United States, 2016. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services</ref>====
	''CDC preferred regimen for '''28 days''' ''		''CDC preferred regimen for '''28 days''' ''
	*[[Raltegravir]] (Isentress; RAL) 400 mg PO twice daily, '''plus'''		*[[Raltegravir]] (Isentress; RAL) 400 mg PO twice daily, '''plus'''
	*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)		*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)

	~~====~~Other Considerations~~====~~		'''Other Considerations'''
	*If known source patient with resistant HIV strain, consult HIV service for source-patient-specific PEP		*If known source patient with resistant HIV strain, consult HIV service for source-patient-specific PEP
	*Consider interactions with current medication interactions and contraindications, such as renal impairment with Truvada		*Consider interactions with current medication interactions and contraindications, such as renal impairment with Truvada

Rossdonaldson1: /* Preferred HIV PEP RegimenKuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 1...

2017-11-19T19:05:32Z

← Older revision		Revision as of 19:05, 19 November 2017
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	*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)		*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)

	:^If known source patient with resistant HIV strain, consult HIV service for source-patient-specific PEP		====Other Considerations====
	:^Consider interactions with current medication interactions and contraindications, such as renal impairment with Truvada		*If known source patient with resistant HIV strain, consult HIV service for source-patient-specific PEP
			*Consider interactions with current medication interactions and contraindications, such as renal impairment with Truvada

Rossdonaldson1 at 19:04, 19 November 2017

2017-11-19T19:04:49Z

← Older revision		Revision as of 19:04, 19 November 2017
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	*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)		*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)

			:^If known source patient with resistant HIV strain, consult HIV service for source-patient-specific PEP
	*If known source patient with resistant HIV strain, consult HIV service for source-patient-specific PEP		:^Consider interactions with current medication interactions and contraindications, such as renal impairment with Truvada

	^Consider interactions with current medication interactions and contraindications, such as renal impairment with Truvada

Rossdonaldson1: /* Preferred HIV PEP RegimenKuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 1...

2017-11-19T19:03:34Z

← Older revision		Revision as of 19:03, 19 November 2017
Line 1:		Line 1:
	===Preferred HIV [[PEP]] Regimen<ref>Kuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 10.1086/672271. http://www.jstor.org/stable/10.1086/672271</ref><ref>Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV—United States, 2016. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services</ref>===		===Preferred HIV [[PEP]] Regimen<ref>Kuhar D, et al. Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis. September 2013. 34(9):875-892. DOI: 10.1086/672271. http://www.jstor.org/stable/10.1086/672271</ref><ref>Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV—United States, 2016. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services</ref>===
			''CDC preferred regimen for '''28 days''' ''
	*[[Raltegravir]] (Isentress; RAL) 400 mg PO twice daily, '''plus'''		*[[Raltegravir]] (Isentress; RAL) 400 mg PO twice daily, '''plus'''
	*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)		*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)


			*If known source patient with resistant HIV strain, consult HIV service for source-patient-specific PEP

			^Consider interactions with current medication interactions and contraindications, such as renal impairment with Truvada

Rossdonaldson1 at 18:40, 19 November 2017

2017-11-19T18:40:24Z

← Older revision		Revision as of 18:40, 19 November 2017
Line 2:		Line 2:
	*[[Raltegravir]] (Isentress; RAL) 400 mg PO twice daily, '''plus'''		*[[Raltegravir]] (Isentress; RAL) 400 mg PO twice daily, '''plus'''
	*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)		*[[Truvada]], 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg emtricitabine [Emtriva; FTC] 200 mg)

	~~===3 drug Expanded<ref name="NEJM"></ref>===~~
	*Ritonavir–lopinavir (Kaletra) PLUS either tenofovir–emtricitabine or zidovudine–lamivudine)
	**Two tablets (50 mg of ritonavir with 200 mg of lopinavir per tablet) twice daily, or four tablets once daily
	*Ritonavir plus atazanavir (plus either tenofovir–emtricitabine or zidovudine–lamivudine
	**100 mg of ritonavir plus 300 mg of atazanavir once daily
	*Ritonavir plus darunavir (plus either tenofovir–emtricitabine or zidovudine–lamivudine)
	**100 mg of ritonavir plus two tablets, each containing 400 mg of darunavir, once daily