Guidelines for Post Exposure Prophylaxis (PEP) for HIV

Mersey, Cheshire, and North Wales HIV Managed Care Network PEP Guidelines Version 5. 01/07/2016

Guidelines for Post Exposure Prophylaxis (PEP) for HIV:

Occupational and Sexual Exposure

Authors of this version: On behalf of the Mersey, Cheshire, and North Wales HIV Managed Care Network: P Hine, R Thomson-Glover, M Chaponda, MD Lawton, U Andrady

Abbreviations GUM = Genitourinary Medicine PEP = Post Exposure Prophylaxis

**Please check you are using the most up to date version of this guideline: liv.ac.uk/hiv**

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Mersey, Cheshire, and North Wales HIV Managed Care Network PEP Guidelines Version 5. 01/07/2016

Introduction

Background to PEP PEP is HIV treatment given as soon as possible following exposure to HIV in an attempt to prevent infection with the virus.

Immediate risk assessment is crucial to establish whether the individual is at significant risk. This is dependent on the type of exposure and the "source" of exposure. The longer the delay to risk assessment and administration of PEP, the less effective PEP is likely to be. If in A+E, patients should have a priority triage to be seen as soon as possible by an appropriate clinician, and not in time order. The assessment can be performed in A+E minors.

PEP consists of 28 days of combination antiretrovirals (3 drugs) with potential side effects. For this reason it is crucial that the potential benefits of PEP outweigh the risks and the individual is well informed.

Purpose and Scope The guideline offers recommendations on how to assess risk following a potential exposure to HIV, and how and when to prescribe post exposure prophylaxis medication. This includes both sexual and occupational exposures.

The guideline is for use in locations within the Mersey, Cheshire, and North Wales HIV Managed Care Network. The guideline is for clinicians in areas of first contact with individuals potentially exposed to HIV; this may include those working in A&E, Infectious Diseases, Occupational Health, and Sexual Health clinics. The responsibility for the implementation and audit of these guidelines lies with the Clinical Leads of those respective departments at each site. The guideline should be used in conjunction with formal training sessions.

This guidance refers primarily to the issue of HIV post-exposure prophylaxis. Consideration must also be given to risk of exposure to hepatitis B and hepatitis C; further details are given below.

This guideline is for individuals over 16 years of age, for children younger than this please refer to the CHIVA guidelines (.uk), or seek advice from the Alder Hey Infectious Diseases Team.

Changes from Previous Version These guidelines now reflect new recommendations from the BASHH PEPSE guidelines and the Expert Advisory Group on AIDS. PEPSE is not routinely recommended after any type of sex or occupational exposure with HIV-positive source on antiretroviral therapy (ART)with a confirmed and sustained(>6 months) undetectable plasma HIV viral load( ................
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