Post exposure prophylaxis for HIV (PEP)

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Post exposure prophylaxis for HIV (PEP)

In June 1981, first cases of HIV was identified in Los Angeles, USA. The worldwide increase in HIV-positive individuals reached an all-time high to approximately 39 million, with significant variation of numbers between countries. The latest report on HIV estimates for India states that there are around 24 Lac HIV-positive people in India. The first documented HIV infection in India was discovered among female sex workers screened for HIV in Chennai, Tamil Nadu, in 1986.


Post-exposure prophylaxis (PEP) is a course taken after any potential exposure to HIV. It consists of a combination of antiretroviral medicines within a period of 28 days to treat while preventing HIV from entering the body from all possible means of exposure.

The principle time delays for the introduction of PEP is not later than 2 hours and preferably1324 with risk thereafter within 72 hours.

PEP must be started no later than 72 hours after exposure, but it needs to be given as resistant as possible. Studies on aminals have reported the administration of PEP within 12, 24 or 36 hours being more effective than within 38 or 72 hours after exposure. 

 HIV Transmission Risk by Different Routes (WHO data)

HIV transmission rates differ with the type of exposure involved.

  • Blood transfusions pose the highest risk with a rate of over 98%.
  • Perinatal transmission, without any intervention, can go up to 40 percent from the baseline of 20 percent.
  • Sexual intercourse carries varying risks based on the type: vaginal intercourse has a transmission rate of 0.05%-0.1% while anal sex is between 0.065-0.5%, and oral intercourse is with risk figures ranging between 0.005%-0.01%.
  • Injection drug use has a transmission rate of 0. 67%, while needle stick exposure has a risk of 0.3%. Splashes affecting the mucous membrane with eyes or Oro-nasal areas cause 0.09%. By contrast, the chances of HBV exposure from a needle puncture vary from 9 to 30 percent, whereas for HCV, it is between 1%-1.8%.

Who should take it?

People who had a potential HIV exposure:

  • Unprotected sex with someone who might have HIV
  • Sharing needles
  • Needlestick injury
  • Sexual assault

Effectiveness of PEP:

PEP is not 100% effective, its effectiveness depends on various factors: –

  • Timing of initiation
  • Adherence to regimen
  • Type of exposure

Studies suggest that if PEP is taken within 72 hours of potential exposure to HIV, it helps in preventing the infection by approximately 80%.

Who can prescribe PEP?

PEP should be prescribed by a qualified doctor who can assess the risk and urgency of taking PEP.

Disclaimer

This article is not a substitute for professional advice and is intended for informational purposes only. This article is for general awareness. 



Blog By Dr. Amit Harshana

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