Post Exposure Prophylaxis (PEP)

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Immediately on exposure take the following steps;

  • Use soap and water to wash any wound or skin site that came into contact with infected blood or fluid
  • Flush exposed mucous membranes with water
  • Irrigate open wound with sterile saline or povidone iodine solution
  • Irrigate eyes with clear water, saline or sterile eye irrigants
  • Report to concerned authority
  • Ascertain the HIV status of the patient and the injured health worker after appropriate counselling
  • Take antiretrovirals immediately after exposure- these should be started within one hour if possible and at the latest 72 hours after exposure.

Criteria for initiating PEP

  • Person is not already known to be HIV positive
  • The source patient is known to be HIV positive

OR

  • HIV status of source patient is unknown

OR

  • It is impossible to identify the source patient

 

 

Recommended

Alternatives

Adults

TDF + 3TC + ATV/r**

         OR

TDF + 3TC + LPV/r

TDF + 3TC + DTG*

Children

AZT + 3TC + LPV/r 

OR

ABC+3TC+ LPV/r

ABC + 3TC + DTG*

*DTG is approved for use among children older than six years and weighing more than 15 kg and is widely available for children weighing at least 20kg who can take 50mg film-coated adult tablets.

**ATV/r can only be used in adolescents >35kg.

Dosing of all drugs is the same as in ART. The course should be continued for 28 days. Enhanced adherence counselling is important for patients.

Note: PEP is not 100% effective, therefore, counselling of exposed persons to consistently and correctly use condom until a negative result at 6 weeks is recommended.

For more detailed information see the National Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care.