Post-exposure prophylaxis for HIV

Post-exposure prophylaxis (PEP) is a medical response given to prevent the transmission of pathogens after potential exposure. The PEP for HIV refers to a set of comprehensive services to prevent HIV infection in exposed individuals where the exposure can be occupational or non-occupational (nPEP) and the provision of short-term (28 days) antiretroviral drugs depending on risk assessment with follow-up. High concentration of free infectious virus and virus-infected cells have been reported in blood, genital fluids and cerebrospinal fluid. The average risk of HIV infection after percutaneous exposure to HIV-infected blood is 0.3%. The nPEP can be offered for cases like unprotected sexual exposure, sexual assault survivors, injecting drug users (IDUs) sharing equipment, etc. While considering PEP, evaluation of exposure, exposure source and exposed person is to be done and 2 or 3 drug PEP (depending upon the type of exposure) can be started within 72 h and need to be continued for 28 days. Drugs preferred are zidovudine + lamivudine. If needed, a boosted protease inhibitor can be added.