S48(2) Post Exposure

Question 1

Exposed to bodily fluids potentially infected with HIV -> take treatment for 28 days

Answer 1

Preferred regimen for PEP x 28 days: tenofovir disoproxil fumarate + emtricitabine + either (dolutegravir or raltegravir)

Most effective if started ASAP and within 72 hrs of exposure

Question 2

Increasingly an outpatient disease to be managed so you need to know where the guidelines are as they’re often not included in non-ID guidelines

Answer 2

True

Question 3

A Few Other Things to Consider for Persons Living With HIV (PLWH)

Answer 3

Transitions of care are imperative

HbgA1c not as reliable with ART -> use fasting BG levels

Lipid profile

Mental health implications

Pain management -> HIV pain management guidelines

Substance use and abuse

HIV in the elderly

Treatment as prevention (TasP -> U=U) and impact on sex life

Question 4

Don’t forget about additional vaccine coverage

Answer 4

Vaccine for HIV in development

HAV and HBV

HPV

Influenza annually – avoid live vaccine if CD4 < 200

Meningococcal A,C,W,Y x 2 doses and q5years

MMR: if born after 1957 need titer and/or vaccine

Tdap x 1 then Td q10years

PCV13 x 1 the PPSV q5years

VZV