Recommendations forpost-exposure prophylaxis

Recommendations forpost-exposure prophylaxis

Post-exposure prophylaxis should be
initiated ideally within 2 hours and no
later than 72 hours following exposure.
Issues relating to potential benefits,
unproven efficacy, potential side effects,
the need for adherence to the treatment
regime, signs and symptoms of primary
HIV infection as well as the need
for clinical and laboratory monitoring
and follow-up must be discussed.
The recommended protocol for postexposure
prophylaxis consists of
ziduvodine plus lamivudine together with
a protease inhibitor, all taken orally:
Alternatives to the first two drugs are:
􀂄 Instead of zidovudine use stavudine
– 40 mg twice daily for bodyweight
more than 60 kg, 30 mg daily if
bodyweight lower than 60 kg
􀂄 Instead of lamivudine use didanosine
- 400 mg daily if bodyweight more
than 60 kg, 250 mg daily if
bodyweight lower than 60 kg.
Before starting, blood should be taken
for full blood count (including differential
and platelets) and liver function tests.
These will serve as baselines for
monitoring of side-effects. Prophylaxis
should be taken for 4 weeks.
Follow-up care and support
P o s t - e x p o s u r e c a r e i n v o l v e s
simultaneous attention to multiple
issues: the emotional state of the
exposed patient, adherence to the postexposure
prophylaxis regimen,
monitoring for potential adverse effects
and sequential HIV testing to exclude
acquisition of infection.