Updated guidelines for nonoccupational exposusure to HIV that were just released by the Centers for Disease Control and Prevention urge health care providers to quickly evaluate people when nonoccupational postexposure prophylaxis (nPEP) is sought, including testing where warranted, and, in cases where blood test results aren’t available, initiating nPEP “without delay.”
The new evidence-based guidelines update and expand 2005 US Department of Health and Human Services and “are intended to assist US clinicians in reducing the occurrence of new HIV infections through effective delivery of nPEP to patients shortly after they have a single exposure outside of health care settings to blood, genital secretions, or other potentially infectious body fluids that might contain HIV.”
According to a summary of the guidelines posted on the US Centers for Disease Control and Prevention (CDC) website, “this update incorporates new scientific evidence from human and animal studies and includes pediatric dosing information.”
The availability of newer antiretroviral drug regimens and recently published estimates of nPEP cost-effectiveness in part prompted the update, according to the summary.
The guidelines note that: “All persons offered nPEP should be prescribed a 28 day course of a 3-drug antiretroviral regimen,” and they stipulate the preferred regimen is tenofovir disoproxil fumarate (300 mg) with emtricitabine (200 mg) (Truvada, Gilead) once daily plus raltegravir (Isentress, Merck) 400 mg twice daily or dolutegravir (Tivicay, Viiv) 50 mg daily. [
The guidelines also stress education and access to screening for other sexually transmitted infections where warranted.
CDC. Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Non-occupational Exposure to HIV – United States, 2016.