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Post exposure prophylaxis answers (172)

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Q: 

got jaundice due to atazonavir

A: Response from Dr. Young Hello Doctor and thank you for your post. First, elevated bilirubin and scleral icterus (or jaundice) is a common, but usually medically insignificant complication of atazanavir (Reyataz) use. The hyperbilirubminemia resolves once the medication is discontinued and can be particularly problematic for persons who have baseline Gilbert''s syndrome. My concern is the 3-drug regimen that you''re taking- tenofovir and ataznavir have a significant drug-drug interaction that results in inadequate atazanavir levels. Recommended dosing of the regimens that include the two meds includes ritonavir (Norvir) for PK boosting (tenofovir + lamivudine with ritonavir 100 mg + atazanavir 300 mg, all once-daily, with food). Depending on your

Q: 

Is there a chance?

A: Response from Dr. Young Yes, Combivir (AZT + 3TC) is both a medication used for the treatment of HIV infection and for post-exposure prophylaxis. BY...


Q: 

PEP test

A: By using a condom and taking Pos exposure prophylaxis you minimized the chances of getting infected almost to zero. This is only if there was only oral, vaginal or anal sex, and does not cover for cunnilingus or fingering if you had mouth sores or small wounds on the fingers....


post exposure prophylaxis related drugs: H1N1 influenza virus vaccine  · ertapenem  · Invanz  ·
Q: 

Given PEP Need Advice!!!!

A: Response from Dr. McGowan This situation has clearly upset you. Please let me provide you with some reassurance. First, you were using condoms which substantially reduces your HIV exposure risk. Second, you were placed on post exposure prophylaxis (or PEP) very promptly (within six hours of the exposure). PEP is most effective if taken as soon as possible after probable exposure to HIV. Third, it is important that you test yourself for HIV. In the long run, this will give you the peace of my mind you need. Fourth, please complete the full course of PEP and see the doctor who placed you on PEP. The regimen you were placed on is perfectly...


Q: 

Nurse in ER exposed to needle puncture

A: Response from Dr. Pavia Dear R. This is a very tough place to be. There is a resource you should consider, funded by CDC and maintained at San Francisco General called the clinician''s PEP line. It is open 24/7 Phone number 1-888-HIV-4911. That will connect you with people who eat sleep and breathe post exposure prophylaxis (PEP. To answer you questions though. The addition of a protease inhibitor offers a theoretic benefit (as would the addition of an NNRTI) but it has not been proven. We don''t know if the benefit is real and if so how large. When the risk is high, it is often recommended, however. The risk of the PEP regimens for 1 month appears to be very modest. Fatigue, nausea and headache are pretty common,...


Q: 

Prophylactic Combivir

A: Response from Dr. Wohl I am a little unsure of the specifics of your exposure, or if you really had a true exposure. If you were wearing a condom during oral and vaginal sex, then you have hardly any chance of acquiring HIV from this experience and do not warrant post-sexual exposure prophylaxis with HIV medications. If you did sustain a more risky exposure, then some would recommend some form of post-exposure treatment. The data however for this approach is limited and not based on treatment of humans following sexual exposure. Certainly,

Q: 

treatment now or can it wait 6 months?

A: Response from Dr. Young Thanks for your post. post-exposure prophylaxis is only effective in the first few days after a known exposure (whether its sexual or occupational). PEP is recommended by the Centers for Disease Control and Prevention for circumstances that include sexual exposures, including rape. Unfortunately, in your circumstance, given the delay in the time of your exposure to a possible start date, there is little or no benefit to starting post-exposure prophylaxis. That said, it would still be important to get follow up testing...


Q: 

3 year old stuck by needle

A: Response from Dr. Wohl Hopefully, you took your daughter to an emergency room or doctor''s office for care. I would still be concerned regarding this exposure regardless of which part of this used needle your daughter was stuck with. There are three major viruses you need to be concerned about: HIV, hepatitis C virus and hepatitis B virus. Your daughter should be immunized against hepatitis B virus already. There is nothing to do about hepatitis C except test her now (ouch) and re-test her in a few weeks (ouch again). As for HIV, post exposure prophylaxis started within 72 hours is recommended for appropriate exposures. It is a hard decision but I hope a person well...


Q: 

PEP Queation

A: Response from Dr. Wohl The most recent CDC guidelines on post exposure prophylaxis following occupational expsoure at found at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm. These guidelines suggest that 2 drug therapy is okay for less severe exposures with 3 drug therapy indicated for more substantial exposures. I disagree and feel that if therapy is deemed justified by the extent of the risk of HIV transmission involved, then full treatment with at least 3 medications is required. For info on non-occupational exposures go to: http://www.thebody.com/content/prev/art6088.html In both cases prophylaxis should...


Q: 

condom burst

A: Response from Dr. Pierone Hello, the situation that you describe is not unusual. We now offer PEP, or post exposure prophylaxis, to reduce the risk of transmission of HIV following an exposure. The risk of transmission depends on a number of factors including the viral load of your partner. In general, the lower the viral load, the lower the chance of transmission of virus. The absolute risk for one sexual exposure is quite low, probably in the range of 0.2% (1/500). This low risk is reduced even further by taking medications. If you took Epivir (3TC) alone for PEP this is somewhat unusual (2 or 3 meds are typically combined), but should still be active. The flu that...


 
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