PEP Treatment

PEP Treatment – All about the ‘Post-Exposure Prophylaxis for HIV’

Hello! Vanakkam and Namaste & Welcome to Dr. Shah’s Clinic. This is Dr. Shah Dupesh,  consultant sexology doctor in Chennai. In this quick 4 minutes read I am going to tell you briefly about PEP treatment also called as post-exposure prophylaxis for HIV.

What is PEP?

An estimated 35 million people are living with HIV. Sadly a large number of people get infected accidentally during work or in some cases sexual assault. PEP also called as post-exposure prophylaxis for HIV is a short term course of anti-retroviral medications that reduce the chances of contracting a HIV infection especially after unprotected intercourse, occupational injury, needle stick injury or shared drug use.

PEP treatment for the prevention of HIV should be offered as early as 24 hours after potential exposure, and definitely within 72 hours of exposure. Beyond 72 hours, the efficacy of the PEP treatment declines significantly.

Does post-exposure prophylaxis work?

PEP treatment for HIV works best when the medications are taken in the first 24 hours or better yet at the ‘earliest possible time after a potential exposure’. When given at the right time frame, pep treatment has been found to be 80% effective. But most importantly, adherence to the full course of 28-day treatment is usually required.

Recent studies suggest that only about 40% to 50% of patients seem to complete the course of treatments

What is PEP Regimen?

The WHO recommended regimen for pep treatment is a drug combination of Tenofovir combined with either lamivudine or emtricitabine as a preferred backbone drug. A recommended third drug is ritonavir-boosted lopinavir.  All these drugs have been routinely used in HIV treatment protocols.

Although newer drugs are available the three-drug combination has been found to be effective in the prevention of HIV

Can seroconversion occur during PEP?

Interestingly, the scientific literature suggests that there are a few cases of patients testing positive post a PEP treatment. In these events, the infection has probably happened due to a wild type virus infection. All said and done, PEP is not a fail-safe method of preventing HIV. But it is the best we can do for the time being.

For patients initiating pep treatments, a baseline testing with ELISA is recommended in addition to testing for Hepatitis B and Hepatitis C. Once the post-exposure prophylaxis treatment is complete, patients must undergo repeat testing at 3 months & once again at 6 months. In some patients, depending on the type of exposure and risk, repeat testing after 1 year has been recommended.

Who should be given PEP?

Clear candidates for PEP include

  1. Men who have sex with men
  2. Bisexual individuals
  3. People who engage in in multiple encounters outside of a stable relationship
  4. Shared needle users as in drug abuse
  5. Occupational exposure for healthcare workers

Is PEP Treatment Dangerous?

The newer drugs seem to have a better tolerance profile for patients. Common side effects reported by patients while on PEP include

  1. Nausea
  2. Headache
  3. Gastritis
  4. And Fatigue

Most of these symptoms are transient in nature, and will spontaneously subside on their own.

That about summates our short article on post-exposure prophylaxis treatment for HIV. Please feel free to get in touch with us if you are worried. We will definitely help you through your problems. This is Dr. Shah, consultant andrologist. I will be happy to help you.

Get in touch with us here or directly at the address mentioned below

Dr. Shah’s Clinic for Male Infertility & Sexual Health
No 5, Hindi Prachar Saba Rd, Parthasarathi Puram, T. Nagar, Chennai, Tamil Nadu 600017
Timing – 9:00 am to 6: 00 pm
Ph.No – 9789843856

References

  1. https://www.who.int/hiv/topics/prophylaxis/info/en/
  2. https://www.nejm.org/doi/full/10.1056/nejmcp0904189

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