Treatment After Exposure To HIV

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AIDS Factsheet

Preventing HIV Infection

Treatment After Exposure To HIV

WHAT IS POST-EXPOSURE PROPHYLAXIS?

AIDS FACT-SHEET

Background Information
-What is AIDS?
-HIV Testing
-Acute HIV Infection
-How HIV Drugs Get Approved
-HIV Life Cycle

Laboratory Tests
-Normal Laboratory Values
-Complete Blood Count (CBC)
-Chemistry Panel
-Blood Sugar and Fats
-CD4 (T-cell) Tests
-Viral Load Tests
-HIV Resistance Testing
-Monitoring Drug Levels

Preventing HIV Infection
-Stopping the Spread of HIV
-How Risky Is It?
-Condoms
-Drug Use and HIV
-Harm Reduction and HIV
-Treatment After Microbicides
-Microbicides

Living with HIV
-Choosing an HIV Care Provider
-Medical Appointments
-Telling Others You are HIV Positive
-Participating in a Clinical Trial
-How to Spot HIV/AIDS Fraud
-Vaccinations and HIV
-Medications to Fight HIV

-HIV Life Cycle
-Taking Current Antiretroviral Drugs
-What Is Antiretroviral Therapy (ART)?
-Adherence
-Treatment Interruptions
-Drug Interactions
-Strengthening the Immune System

-Immune Therapies in Development
-Immune Restoration
-Interleukin-2
-Immune Restoration Syndrome
-Opportunistic Infections

-Opportunistic Infections

Side Effects and Their Treatments
-Side Effects
-Fatigue
-Anemia
-Body Shape Changes (Lipodystrophy)
-Diarrhea
-Peripheral Neuropathy
-Mitochondrial Toxicity
-Bone Problems
-Depression and HIV

Patient Populations

-Women and HIV
-Pregnancy and HIV aids
-Children and HIV
-Older People and HIV

Alternative and Complementary Therapies
-Alternative and Complementary Therapies
-Ayurvedic Medicine
-Chinese Acupuncture
-Chinese Herbalism
-Cat's Claw
-DHEA
-DNCB (Dinitrochlorobenzene)
-Echinacea
-Essiac
-Marijuana
-Silymarin (Milk Thistle)

-Nutrition
-Nutrition
-Vitamins and Minerals
-Exercise and HIV
-Smoking and HIV

Prophylaxis means disease prevention. Post-exposure prophylaxis (or PEP) means taking antiviral medications as soon as possible after exposure to HIV, so that the exposure will not result in HIV infection. These medications are only available with a prescription. PEP should begin within as soon as possible after exposure to HIV but certainly within 72 hours. Treatment with 2 or 3 antiviral drugs should continue for 4 weeks, if tolerated.

WHO SHOULD USE PEP?
Workplace exposure
PEP has been standard procedure since 1996 for healthcare workers exposed to HIV. Workers start taking medications within a few hours of exposure. Usually the exposure is from a "needle stick", when a health care worker accidentally gets jabbed with a needle containing HIV-infected blood. PEP reduced the rate of HIV infection from workplace exposures by 79%. However, some health care workers who take PEP still get HIV infection.

Other exposure
In 2005, the Centers for Disease Control reviewed information on PEP. They concluded that it should also be available for use after HIV exposures that are not work-related. People can be exposed to HIV during unsafe sexual activity, when a condom breaks during sex, or if they share needles for injecting drugs. Infants can be exposed if they drink breast milk from an infected woman. 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?
HIV exposure at work is usually a one-time accident. Other HIV exposures may be due to unsafe behaviors that can occur many times. Some people 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 exposure:

There is no research to show that PEP works for non-occupational exposure. We don't know how soon after exposure to HIV someone has to start PEP.
PEP is not a "morning-after pill". It is a program of several drugs, several times each day, for at least 30 days. PEP costs between $600 and $1,000.
For best results, you have to take every dose of every PEP medication. Missing doses could mean that you develop HIV infection. It could also allow the virus to develop resistance to the medications. If that happens they would no longer work for you.
The medications have serious side effects. About 40% of health care workers did not complete PEP because of the side effects.

Despite these concerns, there is growing interest in PEP for non-occupational exposure. Most programs include counseling to inform and encourage people to avoid exposure to HIV.

HOW IS PEP TAKEN?
PEP should be started as soon as possible after exposure to HIV. The medications used in PEP depend on the exposure to HIV. The following situations are considered serious exposure:

Exposure to a large amount of blood
Blood came in contact with cuts or open sores on the skin
Blood was visible on a needle that stuck someone
Exposure to blood from someone who has a high viral load (a large amount of virus in the blood).

WHAT ARE THE SIDE EFFECTS?
The most common side effects from PEP medications are nausea and generally not feeling well. Other possible side effects include headaches, fatigue, vomiting and diarrhea.

THE BOTTOM LINE
Post-exposure prophylaxis (PEP) is the use of antiviral drugs as soon as possible after exposure to HIV, to prevent HIV infection. PEP can reduce the rate of infection in health care workers exposed to HIV by 79%.

The benefits of PEP for non-occupational exposure have not been proven. This use of PEP is controversial because some people fear it will encourage unsafe behaviors.

PEP is a four-week program of two or three antiviral medications, several times a day. The medications have serious side effects that can make it difficult to finish the program. PEP is not 100% effective; it can not guarantee that exposure to HIV will not become a case of HIV infection.

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AIDS Factsheet

Preventing HIV Infection

Treatment After Exposure To HIV