Recommendations for PEP 2016

Definition

Post exposure prophylaxis are the treatment steps taken by an individual after an exposure to a suspected HIV
contact through a blood or body fluid spill or an un protected sexual intercourse with a suspected HIV
individual e.g a condom burst,human bite,blood spill into eyes, contaminated Needle prick etc

What to do in case of any of the above

Encourage bleeding incase of needle prick -DONOT suck

Wash with soap and water

Irrigate memebranes with water (incase of spill into the eyes)

Donot scrub site of injury

Inform your supervisor immediately

Go to a nearest HTS counselor for support

Next steps:

Go for an urgent HIV test before expiry of 72 hours (the early the better the outcomes)

If HIV negative, you qualify for ARVs for prophylaxis (28 days)

If HIVpositive,you will be counseled and referred for treatment to your preferred Comprehensive clinic

On going and supportive counselling is key for clients on PEP Prophylaxis

After 28 days of treatment,you will be required to go back for a review at the clinic:-this involves a HIV
test to confirm if Negative.

If Negative,discontinue ARVs and supportive counseling depending on the mental stability of the client.

Depending on the outcome of this test outcome, the counselor will advice you accordingly
 Recommendations for PEP 2016
Regimen
A regimen for post-exposure prophylaxis for HIV with two ARV drugs is effective, but three drugs are
preferred
Post-exposure prophylaxis ARV regimens for adults and adolescents:
TDF + 3TC (or FTC) is recommended as the preferred backbone regimen for HIV post-exposure prophylaxis
for adults and adolescents
LPV/r or ATV/r is recommended as the preferred third drug for HIV post-exposure prophylaxis for adults and
adolescents
Where available, RAL, DRV/r, or EFV can be considered as alternative options.
Post-exposure prophylaxis ARV regimens for children 10 years:
AZT + 3TC is recommended as the preferred backbone regimen for HIV post exposure prophylaxis for
children aged 10 years and younger
ABC + 3TC or TDF + 3TC (or FTC) can be considered as alternative regimens
LPV/r is recommended as the preferred third drug for HIV post-exposure prophylaxis for children younger
than 10 years
An age-appropriate alternative regimen can be identified among ATV/r, RAL, DRV, EFV and NVP
Summary:

PEP should be offered as soon as possible (< 72 hours) after high risk exposure

The recommended ARV agents for PEP are:

TDF + 3TC + ATV/r for 28 days (adolescents and adults)

ABC + 3TC + LPV/r for 28 days (children)

Clinical considerations:
NVP should not be used in children above the age of 2 years.
Prescribing practices
A 28-day prescription of antiretroviral drugs should be provided for HIV post exposure prophylaxis following
initial risk assessment
Support to the clients:
Enhanced adherence counselling (ongoing and supportive counselling) is suggested for individuals
initiating HIV post-exposure prophylaxis

NB:The drugs are available 24/7 in maternity unit