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close this bookNational Guidelines for the Clinical Management of HIV/AIDS - Tanzania (NACP; 2005; 131 pages)
View the documentLIST OF ABBREVIATIONS
View the documentACKNOWLEDGEMENTS
View the documentFOREWORD
Open this folder and view contentsCHAPTER 1: INTRODUCTION
Open this folder and view contentsCHAPTER 2: ORGANIZATION OF HIV/AIDS CARE AND TREATMENT
Open this folder and view contentsCHAPTER 3: HIV/AIDS PREVENTION
Open this folder and view contentsCHAPTER 4: PROTECTIVE MEASURES AGAINST HIV TRANSMISSION
Open this folder and view contentsCHAPTER 5: LABORATORY TESTS IN HIV/AIDS
Open this folder and view contentsCHAPTER 6: HIV/AIDS AND PREGNANCY
Open this folder and view contentsCHAPTER 7: PEDIATRIC HIV/AIDS AND RELATED CONDITIONS
Open this folder and view contentsCHAPTER 8: COMMUNITY AND HOME BASED CARE FOR PEOPLE LIVING WITH HIV/AIDS (PLHA)
Open this folder and view contentsCHAPTER 9: COUNSELLING RELATED TO HIV-TESTING AND TREATMENT ADHERENCE
Open this folder and view contentsCHAPTER 10: MANAGEMENT OF COMMON SYMPTOMS AND OPPORTUNISTIC INFECTIONS IN HIV/AIDS
Open this folder and view contentsCHAPTER 11: MANAGEMENT OF MENTAL HEALTH PROBLEMS IN HIV/AIDS
Open this folder and view contentsCHAPTER 12: MANAGEMENT OF HIV INFECTED PATIENTS USING ANTIRETROVIRAL DRUGS
Open this folder and view contentsCHAPTER 13: ARV THERAPY IN INFANTS AND CHILDREN
close this folderCHAPTER 14: USE OF ARVS IN SPECIAL CIRCUMSTANCES
Open this folder and view contents14.1 People with tuberculosis disease and HIV co-infection
close this folder14.2 Post Exposure Prophylaxis-(PEP)
View the document14.2.1 Occupational exposure
View the document14.2.2 Treatment of an Exposure Site
View the document14.2.3 Exposure Report
View the document14.2.4 Evaluation of the Exposed HCW
View the document14.2.5 Drugs for PEP for HIV
View the document14.2.6 Timing of Post Exposure prophylaxis(PEP)
View the document14.2.7 Duration of Post Exposure Prophylaxis(PEP)
View the document14.2.8 Follow-up of Health care worker Exposed to HIV
View the document14.2.9 Monitoring and Management of PEP Toxicity
Open this folder and view contents14.3 HIV PEP in men and women who have been raped/sexually assaulted
Open this folder and view contentsCHAPTER 15: HIV/AIDS AND NUTRITION
Open this folder and view contentsCHAPTER 16: MANAGEMENT OF ANTIRETROVIRAL MEDICINES
Open this folder and view contentsCHAPTER 17: CERTIFICATION OF HEALTHCARE FACILITIES AS CARE AND TREATMENT SITES
 

14.2.5 Drugs for PEP for HIV

For most HIV exposures a combination of AZT and 3TC should be used. For exposures that pose an increased risk for transmission see Table and Table.

Table 17: Recommended HIV post exposure prophylaxis regimens for injuries

   

INFECTION STATUS OF THE SOURCE

Exposure type

HIV-positive
Class 1+

HIV-positive
Class2+

Source of unknown
HIV status

Unknown source§

HIV- Negative

Less severe

Recommend basic 2-drug PEP++

Recommend expanded 3-drug PEP

Generally, no PEP warranted however, consider basis 2- drug PEP** for source with HIV risk factors

Generally, no PEP warranted; however, consider basic 2-drug PEP** in setting where exposure to HIV infected persons is likely

No PEP warranted

Large volume§§

Recommend expanded 3-drug PEP

Recommend expanded 3 drug PEP

Generally, no PEP warranted; however, consider basic 2-drug PEP**for source with HIV risk factors++

Generally, no PEP warranted; however, consider basic 2- drug PEP** in setting where exposure to HIV-infected persons is likely

No PEP warranted

* HIV- Positive:

Class 1 - asymptomatic HIV infection or known low viral load (e. g., <1,500 RNA copies/mL).

Class 2 - symptomatic HIV infection, AIDS, acute sero-conversion, or known high viral load. If drug resistance is a concern, obtain expert consultation. Initiation of post exposure prophylaxis (PEP) should not be delayed pending expert consultation, and, because expert consultation alone cannot substitute for face- to- face counselling, resources should be available to provide immediate evaluation and follow- up care for all exposures.

† Source of unknown HIV status (e. g., deceased source person with no samples available for HIV testing).

§ Unknown source (e. g., a needle from a sharps disposal container).

¶ Less severe (e. g., solid needle and superficial injury).

** The designation "consider PEP" indicates that PEP is optional and should be based on an individualized decision between the exposed person and the treating clinician. If PEP is offered and taken and the source is later determined to be HIV- negative, PEP should be discontinued.

§§ More severe (e. g., large- bore hollow needle, deep puncture, visible blood on device, or needle used in patient’s artery or vein).

Table 18: Recommended HIV post exposure prophylaxis for mucous membrane exposure and non-intact skin* exposure

 

INFECTIOUS STATUS OF THE SOURCE

Exposure type

HIV-positive
Class 1+

HIV-positive
Class2+

Source of unknown HIV status§

Unknown source

HIV- Negative

Small volume**

Consider basic
2-drug PEP++

recommend basic 2-drug PEP

Generally, no PEP warranted however, consider basis 2- drug PEP†† for source with HIV risk factors

Generally, no PEP warranted; however, consider basic 2-drug PEP†† in setting where exposure to HIV infected persons is likely

No PEP warranted

Large volume§§

Recommend basic 2-drug PEP

Recommend expanded 3 drug PEP

Generally, no PEP warranted; however, consider basic 2-drug PEP†† for source with HIV risk factors

Generally, no PEP warranted; however, consider basic 2- drug PEP†† in setting where exposure to HIV-infected persons is likely

No PEP warranted

* For skin exposures, follow- up is indicated only if there is evidence of compromised skin integrity (e. g., dermatitis, abrasion, or open wound).

HIV- Positive:

Class 1 - asymptomatic HIV infection or known low viral load (e. g., <1,500 RNA copies/mL)

Class 2 - symptomatic HIV infection, AIDS, acute seroconversion, or known high viral load. If drug resistance is a concern, obtain expert consultation. Initiation of postexposure prophylaxis (PEP) should not be delayed pending expert consultation, and, because expert consultation alone cannot substitute for face- to- face counselling, resources should be available to provide immediate evaluation and follow- up care for all exposures.

§ Source of unknown HIV status (e. g., deceased source person with no samples available for HIV testing).

¶ Unknown source (e. g., splash from inappropriately disposed blood).

** Small volume (i. e., a few drops).

†† The designation, "consider PEP," indicates that PEP is optional and should be based on an individualized decision between the exposed person and the treating clinician. If PEP is offered and taken and the source is later determined to be HIV- negative, PEP should be discontinued.

§§ Large volume (i. e., major blood splash).

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