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Human Immunodeficiency Virus (HIV) Non-Occupational Post-Exposure Prophylaxis (nPREP) - MEDIGRAM
28 days of antiretroviral prophylaxis is recommended for atients who seen medical treatment within 72 hours of high risk nonoccupational exposures. High risk exposures include transmission from bodily fluids and needle sticks. Antiviral therapy cannot replace high risky behaviors that avoid HIV exposures, but I'm fascinated by pharmacologic advances in prevention and treatment.
The CDC guidelines are based on animal and observational studies since high quality evidence is limited by ethical and operational concerns. With that in mind, prophylactic therapy is effective with timely medical management.
The CDC recommends a 3-drug regimen based on extrapolation of positive data with 3 or more drugs, increased liklihood of successful prophylaxis, and reduce possible resistance mutations. The preferable regimen includes Truvada TDF/emtricitabine) and Isentress (raltregravir) OR Tivicay (dolutegravir).
Addressing barriers to adherence is crucial for successful pharmacologic therapy.
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