The Centers for Disease Control and Prevention (CDC) has issued new evidence-based guidelines, “Updated Guidelines for Antiretroviral Postexposure Prophylaxis after Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV — United States, 2016” that provide updated recommendations for providers regarding non-occupational post-exposure prophylaxis (nPEP) for exposure to HIV outside the healthcare setting.
The new guidelines expand on the 2005 U.S. Department of Health and Human Services recommendations and are intended to help reduce the development of new HIV infections via effective nPEP administration to patients following a single exposure to blood, genital secretions, or other potentially infectious bodily fluids that may carry HIV. The 2016 updated guidelines include new scientific data from human and animal studies as well as information on pediatric dosing. In addition, it includes consideration of new antiretroviral drugs that were approved since the 2005 guidelines.
New features include the use of rapid antigen/antibody (Ag/Ab) combination HIV tests, revised preferred and alternative 3-drug antiretroviral nPEP regimens, an updated schedule of lab tests of source and exposed persons, updated antimicrobial regimens for prophylaxis of sexually transmitted infections and hepatitis, and a suggested procedures for transitioning patients between nPEP and HIV pre-exposure prophylaxis (PrEP) as appropriate.
Some of the key points in the 2016 guidelines include the following:
— Healthcare providers should evaluate persons rapidly for nPEP when care is sought ≤72 hours after a potential nonoccupational exposure that presents a substantial risk for HIV acquisition
— nPEP is recommended when the source of the body fluids is known to be HIV-positive and the reported exposure presents a substantial risk for transmission
— nPEP is not recommended when the reported exposure presents no substantial risk of HIV transmission
— nPEP is not recommended when care is sought >72 hours after potential exposure
Occupational PEP guidelines for use after possible HIV exposures in healthcare settings were published in 2013.
For more information visit CDC.gov.