hiv post exposure prophylaxis on your medical elective
Download
Skip this Video
Download Presentation
HIV post exposure prophylaxis on your medical elective

Loading in 2 Seconds...

play fullscreen
1 / 34

HIV post exposure prophylaxis on your medical elective - PowerPoint PPT Presentation


  • 392 Views
  • Uploaded on

HIV post exposure prophylaxis on your medical elective. Dr Sarah Barrett Consultant GUM/HIV Birmingham Heartlands Hospital. PEP. PEP. Post Exposure Prophylaxis (PEP) is a course of antiretrovirals that can stop you becoming HIV positive after you\'ve been exposed to the virus. Introduction.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'HIV post exposure prophylaxis on your medical elective' - noam


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
hiv post exposure prophylaxis on your medical elective

HIV post exposure prophylaxis on your medical elective

Dr Sarah Barrett

Consultant GUM/HIV

Birmingham Heartlands Hospital

slide9
PEP

Post Exposure Prophylaxis (PEP) is a course of antiretrovirals that can stop you becoming HIV positive after you\'ve been exposed to the virus.

introduction
Introduction
  • What is high risk?
    • Countries
    • Injuries
  • What do I do if I get a needlestick?
  • What do I need to know about the drugs?
    • Timing
    • Side effects
    • Interactions
    • Cost!
  • How do I get the drugs
    • PEP clinic
    • Reselling of drugs
  • Questions
increased risk overseas
Increased risk overseas...

‘Of the 14 ‘possible’ occupationally acquired HIV infections reported in the UK, 13 had worked in areas of high HIV prevalence and were probably infected abroad’

increased risk overseas12
Increased risk overseas...

‘Of the 14 ‘possible’ occupationally acquired HIV infections reported in the UK, 13 had worked in areas of high HIV prevalence and were probably infected abroad’

why?

increased risk overseas13
Increased risk overseas...

‘Of the 14 ‘possible’ occupationally acquired HIV infections reported in the UK, 13 had worked in areas of high HIV prevalence and were probably infected abroad’

why?

  • Higher prevalence of HIV infection
  • lack of standard infection control measures
  • poor or inadequate equipment leading to increased risk of exposure
  • Relative inexperience/lack of technical skills of students
  • No Post exposure prophylaxis
what is high risk
What is high risk?
  • Risk of acquiring HIV from occupational exposure is LOW
    • Needle stick 3 in 1000
    • Mucocutaneous 1 in 1000
    • Intact skin, urine, vomit, saliva, faeces – negligible
what is high risk21
What is high risk?
  • Risk of acquiring HIV from occupational exposure is LOW
    • Needle stick 3 in 1000
    • Mucocutaneous 1 in 1000
    • Intact skin, urine, vomit, saliva, faeces – negligible
    • Receptive vaginal intercourse 1 in 500
    • Receptive anal intercourse 1 in 30
what is high risk22
What is high risk?
  • Increased risk if
    • Deep injury
    • Visible blood
    • Injury with a needle which had been placed in a source patient’s artery or vein.
    • Terminal HIV-related illness in the source patient.
prevention24
Prevention
  • Wear gloves
  • Do NOT put yourself in risky situations
  • Goggles
  • Safe disposal of needles
  • Wear a condom (!)
following any exposure
Following any exposure
  • Wash liberally with soap and water, don’t scrub!
  • Antiseptics and skin washes should not be used
  • Encouraged gentle bleeding of puncture wounds
  • Irrigate exposed mucous membranes copiously with water
  • Report injury to Dr in charge
    • They need to assess the source patient
slide27
PEP
  • Viral dissemination does not occur immediately
  • leaves a window of opportunity during which PEP may be beneficial
  • Most efficacious if started within the hour
  • Definitely within 72hours
  • If in doubt, take it and stop after further information obtained
the drugs29
The drugs
  • Two Kaletra tablets (protease inhibitor) bd
  • One Truvada tablet (Tenofovir and FTC) od
  • No food restrictions
  • PEP pack can be stored at room temperature
  • Starter pack contains 4 days
  • Should continue for 28 days (enough given to source more locally or come home)
  • Benefits should outweigh risks of drugs
problems with the drugs
Problems with the drugs...
  • Side effects
    • Commonly gastrointestinal (e.g. Nausea and diarrhoea) beware dehydration
    • Dizziness and headache.
    • Skin rash
  • Interactions
    • www.hiv-druginteractions.org
the good news is
The good news is....
  • Antiretroviral medication has become more widely available in high HIV prevalence countries
  • Prior to departure make enquiries whether PEP protocols are established in your elective centre
  • If PEP is not available consider taking a PEP starter pack
the pre elective pep clinic
The Pre-elective PEP clinic
  • You will receive an email containing details about 2 months before departure
  • Risk assessed
  • Baseline HIV test (+ ?confidential STI screen)
  • Written information given
  • Pack with gloves/needles and condoms
  • Prescription for 4 days of drugs if appropriate
  • £96 (cost of drugs only)
reselling of drugs
Reselling of drugs...
  • NOT encouraged!
  • Trust the person you are buying from
  • Ensure drugs are in date
  • Ensure attend PEP clinic
    • Baseline HIV test
    • Instructions
    • Medical kit
ad