Post Exposure Prophylaxis Following Sexual Exposure Flashcards
What is PEPSE?
A combination of highly active anti-retroviral drugs that can be given after HIV exposure to reduce the risk of HIV infection
What is the time window following exposure to possible HIV infection within which PEPSE should be started?
It is vital that PEPSE is given within 72 hours of exposure
What is the single most important risk factor for assessing risk of HIV transmission?
The viral load- much more likely in individuals with a high viral load
What is the recommended PEPSE Regime?
Truvada (Emtricitabine (FTC) and Tenofovir)- Once Daily for 28 days (1 month)
Raltegravir Twice Daily for 28 days
What are some common side effects of PEPSE (truvada OD+ raltegravir BD for 28 days)?
Nausea
Diarrhoea
Headaches
Tiredness
If the sexual contact is known what key piece of information should be checked if possible?
Check their viral load, drug resistance and treatment history
How long is a course of PEPSE?
28 days
Truvada- OD
Raltegravir BD
What factors may affect the efficacy of PEPSE?
Drug resistance- if parter is known HIV positive it is helpful to check drug resistance in their history
Delay to starting therapy
Not completing therapy
Poor adherence to regime (Truvada OD and Raltegravir BD 28 days)
What should be done when a person presents for PEPSE?
Take a full sexual history
Ask about previous HIV tests
Test for HIV and other STIs
Do FBC, U&Es, LFTs
Start Hep B Vaccination if not already done so
Partner notification- encourage testing of partners if indicated
Book a follow up for review and HIV test at 2 weeks and then again 2 months after completing PEPSE
Advice them to abstain from sex or protect partners till completion of PEPSE and a definite HIV result
Where can individuals access PEPSE?
GUM Clinics
Accident and Emergency
Note- All NHS occupational health centres will provide PEPSE (Truvada and Raltegravir) for occupational exposure
