What are the recommended drug regimens for occupational HIV postexposure prophylaxis (PEP)?

Updated: Nov 14, 2019
  • Author: Jason F Okulicz, MD, FACP, FIDSA; more...
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The Public Health Service (PHS) no longer recommends that the severity of exposure be used to determine the number of drugs to be offered in an HIV PEP regimen. Currently, a regimen that contains 3 (or more) antiretroviral drugs is recommended routinely for all occupational HIV exposures.

Examples of recommended PEP regimens include those that consist of a dual nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) backbone plus an integrase strand transfer inhibitor (INSTI), a ritonavir-boosted protease inhibitor (PI), or a nonnucleoside reverse transcriptase inhibitor (NNRTI). [5]

Preferred regimen

Alternative regimens

Alternative regimens may combine 1 drug or drug pair from the INSTI, PI, or NNRTI classes with 1 pair of NRTIs listed below.

INSTI, PI, or NNRTI options include the following:

NRTIs combined with agent(s) selected above include the following:

Alternative antiretroviral agents for use as PEP only with expert consultation include the following:

The following antiretroviral agents are generally not recommended for use as PEP:

The following antiretroviral agent is contraindicated as PEP:

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