Widespread adoption of post exposure prophylaxis (PEP) recommended in US
New guidelines for use of PEP for prevention of HIV transmission in the US were published in the January 21 issue of CDC’s Morbidity and Mortality Weekly Report.
The new guidelines for people exposed to HIV through sexual intercourse, sexual assault, injection drug use or accidents, such as unintentional needlesticks. When used appropriately, this approach, called non-occupational post-exposure prophylaxis (NPEP), can serve as an important safety net to reduce the risk of HIV infection. NPEP is a complex regimen and should not be viewed as a first line defense against HIV infection.
The U.S. Department of Health and Human Services (DHHS) Working Group on Nonoccupational Postexposure Prophylaxis (nPEP) made the following recommendations for the United States.
- For persons seeking care <72 hours after nonoccupational exposure to blood, genital secretions, or other potentially infectious body fluids of a person known to be HIV infected, when that exposure represents a substantial risk for transmission, a 28-day course of highly active antiretroviral therapy (HAART) is recommended.
- Antiretroviral medications should be initiated as soon as possible after exposure.
- No recommendations are made for the use of nPEP following exposure to a person of unknown HIV-status.
- Clinicians should evaluate risks and benefits of nPEP on a case-by-case basis.
- For persons with exposure histories that represent no substantial risk for HIV transmission or who seek care >72 hours after exposure, DHHS does not recommend the use of nPEP. Clinicians might consider prescribing nPEP for exposures conferring a serious risk for transmission, even if the person seeks care >72 hours after exposure if, in their judgment, the diminished potential benefit of nPEP outweighs the risks for transmission and adverse events.
Full guidelines including recommended choice of treatment etc: