In the Journals

CDC updates PEP guidelines for nonoccupational HIV exposure

The CDC released new recommendations for the use of nonoccupational post-exposure prophylaxis, or nPEP, after exposure to HIV outside of health care settings, according to an MMWR announcement.

The recommendations, “Updated Guidelines for Antiretroviral Postexposure Prophylaxis after Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV — United States, 2016,” expand on the 2005 Department of Health and Human Services guidelines. They incorporate new evidence from human and animal trials regarding the delivery of nPEP, new and well-tolerated ART regimens, and updated estimates on the cost-effectiveness of nPEP as an HIV prevention strategy. The guidelines also now include dosing information for pediatric patients.

According to the guidelines, health care providers should:

  • consider nPEP in patients seeking care no more than 72 hours after potential nonoccupational exposure to HIV;
  • prescribe a 28-day course of Truvada (emtricitabine/tenofovir disoproxil fumarate, Gilead Sciences) plus Isentress (raltegravir, Merck) or Tivicay (dolutegravir, ViiV Healthcare) for healthy adults and adolescents suspected of HIV exposure;
  • provide all patients with prevention, treatment and supportive care for other health risks, including bacterial sexually transmitted infections, traumatic injuries, hepatitis B and hepatitis C infection, and pregnancy; and
  • offer counseling and intervention services to patients at risk for recurring HIV exposure, such as injection drug users and people who have sex without condoms.

For more information: Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV – United States, 2016

The CDC released new recommendations for the use of nonoccupational post-exposure prophylaxis, or nPEP, after exposure to HIV outside of health care settings, according to an MMWR announcement.

The recommendations, “Updated Guidelines for Antiretroviral Postexposure Prophylaxis after Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV — United States, 2016,” expand on the 2005 Department of Health and Human Services guidelines. They incorporate new evidence from human and animal trials regarding the delivery of nPEP, new and well-tolerated ART regimens, and updated estimates on the cost-effectiveness of nPEP as an HIV prevention strategy. The guidelines also now include dosing information for pediatric patients.

According to the guidelines, health care providers should:

  • consider nPEP in patients seeking care no more than 72 hours after potential nonoccupational exposure to HIV;
  • prescribe a 28-day course of Truvada (emtricitabine/tenofovir disoproxil fumarate, Gilead Sciences) plus Isentress (raltegravir, Merck) or Tivicay (dolutegravir, ViiV Healthcare) for healthy adults and adolescents suspected of HIV exposure;
  • provide all patients with prevention, treatment and supportive care for other health risks, including bacterial sexually transmitted infections, traumatic injuries, hepatitis B and hepatitis C infection, and pregnancy; and
  • offer counseling and intervention services to patients at risk for recurring HIV exposure, such as injection drug users and people who have sex without condoms.

For more information: Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV – United States, 2016