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What is post exposure prophylaxis _PEP_

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What is post exposure prophylaxis _PEP_ Powered By Docstoc
					Managing accidental exposure

• The first step:

  - implement universal precautions

• Also:

  - educate staff about all transmission routes
  - provide condoms in workplace


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What is post-exposure prophylaxis?
(PEP)

Short-term treatment with antiretroviral drugs

to reduce the likelihood of HIV infection

after potential exposure

through occupational accident or through sex


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Managing occupational exposure
1. First aid
2. Assess risk associated with exposure
3. Evaluate source for HIV infection
4. Counseling on implications of exposure
5. Clinical evaluation & baseline testing (after consent)
6. Provide PEP (when appropriate)
7. Advise on secondary prevention
8. Counseling on reducing future risk
9. Exposure report
10. Follow-up HIV testing (6w, 3m, 6m)
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11. Follow-up counseling and care
Before starting PEP:

Explain:

• Risk of infection vs toxicity of drugs

• ? Effectiveness (treatment failure)

• Side effects of drugs

• Need to complete full course

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ARV treatment for PEP

• Start drugs as soon as possible (2 to 4 hours)

• Combination treatment (2 or 3 drugs)

   Zidovudine & Lamivudine

   Third drug: Indinavir or Effavirenz

• Treatment duration: 2 to 4 weeks

• Monitor for toxicity
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What needs to be in place to
implement PEP?

• Prevention - universal precautions

• Organizational policy / guidelines

• Staff awareness - training / supervision

• Counseling capacity

• Supplies

• Medical care / referral possibility
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posted:7/28/2013
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