HIV PEP

BASHH regimen: emtricitabine/tenofovir (Truvada) AND raltegravir

Given following possible exposure to HIV
Indication: Typically after UPSI with HIV+, viral load +ve person (risk with anal > vaginal)
Mechanism of action: Inhibit early viral replication (emtricitabine with tenofovir disoproxil plus raltegravir)
Advantages: Usually well tolerated
Reduces likelihood of seroconversion by 80%
Adverse effects: -
Contraindications: Severe renal/liver failure. Stopping Truvada may rarely trigger flare of Hep B
Should not be taken with Rifampicin
Administration: 28d course, starting no later than 72h from exposure. Starter packs in A&E typically only cover 3-5 days - refer to sexual health clinic

other important considerations

  • is there a risk of co-infection?
  • some sources quote 82% of HIV infected individuals to be co-infected with Hepatitis C, however there is no PEP available