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Post exposure prophylaxis answers (172)

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Q: 

possible exposure/unknown source

A: I"m going to assume that the instruments were soaking in a solution that is designed to kill any lingering bacteria or virus. Honestly, if they were soaking for 8 hours, I highly doubt that you are at risk. However, you should definitely discuss this incident with your supervisor and fill out an incident report so its on record that you did have a possible work exposure. In the future, you should know that there is such a thing as PEP (post exposure prophylaxis) HIV treatment. This should be available through any of the Emergency Rooms that you work with.   The CDC MMWR has Public Health recommendations concerning occupational exposure and it would be...


Q: 

why would i get kaletra and prezista (?) for exposure only?

A: Response from Dr. Young Hello and thank you for your post. Since Prezista (darunavir) and Kaletra (lopinavir/ritonavir) are both HIV protease inhibitors, there is rarely any circumstance where both would be prescribed at the same time. post-exposure prophylaxis (PEP) regimens are usually made up of two NRTIs (like Combivir or Truvada) with a third medication (sometimes Kaletra, but other medications are also used). One could consider simplifying your regimen to only the 4 daily Kaletra tablets; all PEP regimens should be taken for 4 weeks (or 1 month). You should be sure to get follow up HIV testing too. Be well,BY...


Q: 

prophylaxis

A: Response from Dr. Young Hello and thanks for your post. post-exposure prophylaxis should be started under medical supervision, so I hope that you''re not doing this solo. The usual dose for AZT/3TC is AZT 300 mg + 3TC (lamivudine) 150 mg twice daily. PEP regimens should be taken for 4 weeks. I hope this helps.BY...


Q: 

known exposure

A: Response from Dr. Young Hello and thank you for your post. post-exposure prophylaxis should be started as soon as possible after the exposure and definitely within 72 hours (afterwards, there''s little benefit). The availability of the medications is probably subject to local policy and protocol, but if you live in the US, you should be able to receive medications promptly in commercial pharmacies (just call around to check on the availability, don''t take no for an answer). Good luck and good health,BY...


Q: 

does exposure mean trandmission

A: Response from Dr. Young I''d have to wonder about someone who would intentionally expose you to HIV, not once, but twice. That said, if the exposures have occured within 48 hours, post-exposure prophylaxis (PEP) with antiretroviral medications can reduce the likelihood of infection. After that period of time, the effectiveness of PEP is dramatically reduced. I''d advise speaking with your doctor as soon as possible. BY...


Q: 

Help! PEP After exposure missed a dose...or 3

A: Response from Dr. McGowan I am very sorry to hear about your traumatic experience. When it comes to post exposure prophylaxis, it is important to start the PEP regimen as soon as possible after possible HIV exposure. It appears that you did that. Also, you corrected yourself pretty quickly and by day 2 you were taking the medicines as prescribed. Though it is hard to give you a categorical assurance, more than likely you will be OK despite what occurred on day 1 of starting the medicines. Just to be clear the standard adult dose for your PEP regimen is ONE truvada daily and two Kaletra tablets (each tablet is 200/50) twice a day for 28 days. As for other things you might be doing, I am...


Q: 

HIV prophylaxis during pregnancy

A: Response from Dr. Young Thanks for your post. I''m sorry to hear about your possible exposure. If the source''s viral load was undetectable, your chances of infection from this patient and type of exposure should be very low. The combination of Combivir and Kaletra is certainly very potent and is generally considered safe during pregnancy. Further, boosted PIs tend to avoid issues with transmitted drug resistance, mitigating this concern. A recent publication from the late Dr. Ann Morris analyzes the safety of protease inhibitors during pregnancy and suggest that all are generally safe and well tolerated in this setting, with no obvious risk of teratogenicity. Good luck, BY...


Q: 

rape victim - question about when it"s safe to have intercourse again

A: Hi Again, Yes, the emergency department should have offered it to you. They may contact this clinical resource: http://www.nccc.ucsf.edu/    WarmlineNational HIV/AIDS Telephone Consultation Service--800-933-3413 The Warmline provides expert clinical advice on HIV/AIDS management for health care providers, from those with limited access to expert consultation to those with complex antiretroviral resistance dilemmas. The Warmline is available Monday through Friday, 8 a.m. to 8 p.m. EST. You can also schedule an appointment online using the button in the Quick Links box to the right. PEPlineNational Clinicians" post-exposure prophylaxis Hotline--888-448-4911 The PEPline provides around-the-clock...


Q: 

rape victim - question about when it"s safe to have intercourse again

A: Hi Again, Yes, the emergency department should have offered it to you. They may contact this clinical resource: http://www.nccc.ucsf.edu/    WarmlineNational HIV/AIDS Telephone Consultation Service--800-933-3413 The Warmline provides expert clinical advice on HIV/AIDS management for health care providers, from those with limited access to expert consultation to those with complex antiretroviral resistance dilemmas. The Warmline is available Monday through Friday, 8 a.m. to 8 p.m. EST. You can also schedule an appointment online using the button in the Quick Links box to the right. PEPlineNational Clinicians" post-exposure prophylaxis Hotline--888-448-4911 The PEPline provides around-the-clock...


Q: 

Is it to late to take PEP?

A: Response from Dr. Young I''m surprised that our Japanese colleagues couldn''t help you with post-exposure prophylaxis. Unfortunately, your window of opportunity has past. post-exposure prophylaxis isn''t effective if started after 72 hours of the exposure. BY...


 
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