WHAT IS THE TREATMENT AFTER EXPOSURE?
Prophylaxis means disease prevention. Post-exposure prophylaxis (PEP) means taking antiretroviral drugs (ARVs) as soon as possible after exposure to HIV, so that the exposure will not result in HIV infection. These drugs are only available by prescription. The PEP should be taken as soon as possible after exposure to HIV but certainly within 72 hours. Treatment with 2 or 3 ARVs should continue for 4 weeks, if tolerated.
WHO SHOULD USE PEP?
The PEP has been standard procedure since 1996 for workers in the health area are exposed to HIV. Workers start taking medications within a few hours after exposure. Usually the exposure is from an accidental needle stick with a needle containing HIV-infected blood. PEP reduced the rate of HIV infection from workplace exposures by 79%. However, some workers may be infected with HIV who take PEP.
In 2005 the Centers for Disease Control (CDC) has reviewed information on PEP. They have decided to be available also in situations not related to work. People can be exposed by having unprotected sex, in cases of rupture of a condom during sex, or sharing needles to inject drugs. In a study of PEP in 400 cases of possible sexual exposure to HIV, not one person became infected with HIV.
SHOULD PEP BE USED FOR NON-OCCUPATIONAL EXPOSURE?
Exposures at work are usually an incident that occurs only once. Others may be due to risk behaviors that often occur. Some think that PEP might encourage this unsafe behavior if people think that PEP is an easy way to avoid HIV infection.
There are other reasons why PEP might not be a good idea for non-occupational:
There have been no studies to show that PEP works for non-occupational exposure. It is not known how soon have to start PEP after exposure.
PEP is not a "morning after pill." PEP is a program that includes several medications to be taken at least 30 days and cost between $ 600 and $ 1,000.
For best results, you should take every dose of every PEP medication. Skipping doses may result in HIV infection. You can also allow the virus to develop drug resistance. If that happens they stop working.
The medications have side effects. Approximately 40% of workers did not complete PEP regimen due to side effects.
Despite these concerns, there is great interest in the use of PEP for non-occupational exposures. Most programs include counseling to inform and encourage people to avoid exposure to HIV.
HOW IS THE PEP?
The PEP should be initiated as soon as possible after exposure to HIV.
The Public Health in the US recommends using a combination of three antiretroviral approved for four weeks. Previous guidelines were based on the severity of exposure to HIV. This has been eliminated in the guidelines published in 2013. It is now recommended that all exposures are treated the same way.
WHAT ARE THE SIDE EFFECTS?
The most common side effects from PEP medications are nausea and feeling sick. Other possible side effects include headaches, fatigue, vomiting, and diarrhea. For more information, see the fact sheets on individual ARVs.
IN A NUTSHELL
Post-exposure prophylaxis (PEP) is the use of ARVs as soon as possible after exposure to HIV to prevent infection with the virus. PEP can reduce the rate of HIV infection in the area of ??workers health by 79%.
They have not seen the benefits of PEP for non-occupational exposure. This use of PEP is controversial because some believe it may encourage the practice of risky behaviors.
PEP is a program of four weeks and two or three ARVs, several times a day. The medications have serious side effects that may hinder completion of the program. PEP is not 100% effective and there is no guarantee that will prevent infection with HIV.