Prophylaxis after exposure (PEP) should be considered for health care professionals and anyone who are accidently exposed to the risk of HIV infection by needlesticks or other sharp injuries, contact with HIV patients’ blood or biological fluid, or blood transfusion. PEP’s goal is to stop local viral replication before it spreads to the rest of the body, preventing infection.
PEP, on the other hand, is not required when the contact is limited to intact skin or a few drops on the mucous membrane for a short period of time.
It’s also not recommended if the source is confirmed to be HIV-free. Depending on the extent of the HIV risk, the NACO advises two forms of PEP regimens (see box).
Basic (2 drug ) regimen (for low risk)* [wpdatatable id=1]
Expanded (3 drug ) regimen (for high risk)#[wpdatatable id=2]
In developed countries, where a large number of source HIV patients have received one or more anti-HIV regimens and may be harbouring drug-resistant virus, alternative prophylactic regimens using stavudine, didanosine, abacavir, efavirenz have also been used. If the drugs received by the source person is known, prophylactic regimen may be individualized to include at least 2 drugs that the source has not received.
Best time for (PEP) adminstration after exposure.
PEP should be administered as soon as possible after exposure, preferably within 1–2 hours. The possibility of avoiding infection decreases as time passes; some guidelines advise against starting it more than 72 hours after exposure. Others claim that in the event of default, PEP can be initiated as soon as 1–2 weeks afterwards. Though HIV infection cannot be avoided, the latestart PEP may help to postpone the onset of AIDS.
How can One get (PEP) Drug.
PEP is available in all District hospitals and Teaching hospitals that support ‘ Heart to Heart’ centres.