RCH HIV PEP guidelines and referral (doc).docVIP

GUIDELINES FOR POST-EXPOSURE PROPHYLAXIS PEP AFTER NON-OCCUPATIONAL EXPOSURE TO HIV In all cases, contact the Paediatric Infectious Diseases Consultant on call via switchboard 9345 5522 for advice on the need for PEP and to discuss follow-up. Please print this form, circle exposure and drug choice and fax to 座机电话号码 1. Has there been significant exposure to recommend PEP? PEP is recommended 3 drugs when: Source is known to be HIV-positive with vaginal/anal intercourse or shared injecting equipment Source HIV status is unknown with anal intercourse or shared injecting equipment and source from sub-Saharan Africa or a man who has sex with men PEP should be considered 2 drugs when: Source is known to be HIV-positive where exposure is oral intercourse with ejaculation OR blood exposure where the mucosa is NOT INTACT Source HIV status is unknown and vaginal intercourse and source from sub-Saharan Africa PEP is not recommended when: Source is known to be HIV-positive where exposure is oral intercourse with ejaculation where the mucosa is INTACT or exposure of INTACT skin to body fluids Source HIV status is unknown and vaginal/oral intercourse and source not from sub-Saharan Africa Community-acquired needlestick injury For full explanation of risk factor analysis, see: .au/images/publications/guidelines/2007nationalnpepguidelines2.pdf 2. Laboratory tests and follow-up Test Baseline* 6 wks** 3 mths** 6 mths** HIV Hep B*** Hep C STI * Baseline bloods should also be taken from source if known. If source is known to be HIV positive, bloods should also be taken for HIV viral load and resistance testing.** Follow up bloods to be taken at RCH ID clinic. *** Hepatitis B vaccine +/- immunoglobulin if within 72 hours should be administered within 14 days if no protective level of anti-HBs antibodies are shown on serological testing. Routine testing for other sexually transmitted infections eg urine PCR for Chlamydia and Gonorroea 3. PEP medications PEP should be