2. WHAT IS HIV- PEP?
• HIV is the human immunodeficiency virus. It is the
virus that can lead to acquired immune deficiency
syndrome, or AIDS.
• PEP involves taking anti-HIV drugs as soon as
possible after having been exposed
• To be effective, PEP must begin within 72 hours
after exposure, before the virus has the time
rapidly replicate in your body
• PEP consists of 2-3 anti-HIV medications taken
every day for 1 month
3. PEP means Post-Exposure Prophylaxis
• Prophylaxis means disease prevention
• PEP involves taking anti-HIV drugs as soon as
possible after you may have been exposed to
HIV to try to reduce the chance of becoming HIV
positive; occupational PEP (health-care setting)
and non-occupational PEP (condom
breakage, sexual assault, etc.)
• The medications may have side effects that can
make it difficult to finish the program. PEP is not
100% effective; it does not guarantee that
someone exposed to HIV will not become
infected with HIV.
4. Who needs PEP?
• PEP is usually used for anyone who may have
been exposed to HIV.
• Healthcare workers have the greatest risk. They
can be exposed to HIV by:
– Needle sticks or cuts
– Getting blood or other body fluids in their eyes or
mouth
– Getting blood or other body fluids on their skin when
it is scraped, or affected by dermatitis
• The risk of HIV transmission in these ways is
low—less than 1% for each exposure
5. Why can’t PEP therapy be taken after
72 hours from the point of exposure?
• HIV grows faster and faster once it enters
your body.
• If you start taking PEP more than 72 hours
after exposure, the meds can’t keep up, and
research has shown that PEP has little or no
effect in preventing HIV infection after the
72-hour mark.
• Better if PEP starts within 6 hours from
injury
6. Different kind of exposure
• Exposure to a large amount of blood.
• Blood came in contact with cuts or open sores on the
skin.
• Blood was visible on a needle that stuck someone.
• Exposure to blood from someone who has a high viral
load (a large amount of virus in the blood).
• For serious exposures, it is recommended
using a combination of three drugs for four
weeks. For less serious exposure, the
guidelines recommend treatment with two
drugs for four weeks: AZT and 3TC
7. Two drug regimens
• AZT and 3TC: Zidovudine 300 mg BID +
Lamivudine 150 mg BID or Combivir 1 Tab BID
+
• FTC and TDF: Emtricitabine 200 mg OD +
Tenofovir 300 mg OD or Truvada 1 Tab OD
8. Three drug regimens
• Combivir BID or Truvada OD
• Associated with:
– Lopinavir 400 mg and Ritonavir 100 mg BID:
Kaletra 2 tabs BID
or
– Atazanavir 300 mg OD + Ritonavir 100 mg OD:
Reyataz 300 mg OD and Norvir 100 mg OD
11. WHAT ARE THE SIDE EFFECTS?
• The most common side effects from PEP
medications are nausea and generally not
feeling well.
• Other possible side effects include
headaches, fatigue, vomiting and diarrhea.
12. Prevention strategies
• Health care workers should assume that the
blood and other body fluids from all patients
are potentially infectious. They should therefore
follow infection control precautions at all times.
• Routinely using barriers (such as gloves and/ or
goggles) when anticipating contact with blood
or body fluids,
• Immediately washing hands and other skin
surfaces after contact with blood or body
fluids, and
• Carefully handling and disposing of sharp
instruments during and after use.
14. Disposal containers
• Safety devices have been developed to help
prevent needle-stick injuries. If used
properly, these types of devices may reduce
the risk of exposure to HIV.
• Many percutaneous injuries, such as needle-
sticks and cuts, are related to sharps disposal.
Strategies for safer disposal, including safer
design of disposal containers and placement
of containers, are being developed.
17. Conclusions
• Post-exposure prophylaxis (PEP) is the use of
anti-HIV drugs as soon as possible after
exposure to HIV, to prevent HIV infection. PEP
can reduce the rate of infection in health care
workers exposed to HIV by 79%.
• The benefits of PEP for non-occupational
exposure have not been proven. This use of
PEP is controversial because some people fear
it will encourage unsafe behaviors.
