HIV Prophylaxis Following Occupational Exposure
This guideline was prepared and published by the NYS DOH AIDS Institute HIV Clinical Guidelines Program. It has been republished here. Please note that recommendations are assigned an evidence-based rating and use the rating scheme developed by the Department of Health and Human Services.
|What's New -- October 2012 Update|
|Significant revisions include the following:
*Lamivudine may be substituted for emtricitabine.
The purpose of these guidelines is to provide recommendations for prescribing HIV post-exposure prophylaxis (PEP) following occupational exposure. To develop these guidelines, the New York State Department of Health AIDS Institute's (NYSDOH AI) Medical Care Criteria Committee has reviewed available literature addressing the biologic efficacy, effectiveness, and implementation of PEP, as well as current standards for the use of antiretroviral therapy (ART) in established HIV infection. Because randomized, placebo-controlled clinical trials of PEP in humans have not been conducted and are not feasible to design, the NYSDOH AI guidelines are based on existing published studies, best-practice evidence, and the considered opinion of the expert clinicians in the field of adult HIV medicine who comprise the Medical Care Criteria Committee. Expert opinion was frequently used to arrive at recommendations as the PEP literature leaves many questions unanswered or poorly studied.
New York State recommendations differ from those published by the Centers for Disease Control and Prevention (CDC) (see Appendix B). The guidelines of this committee stress simplicity and tolerability in the approach to PEP, recommending a potent but very well tolerated first-line triple therapy for all significant exposures. Recommended second choice regimens are potent and include the best tolerated boosted protease inhibitors.
These 2012 guidelines update any previously issued guidelines. Revisions are summarized in the What's New box above.
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Cite this: HIV Prophylaxis Following Occupational Exposure: Guideline and Commentary - Medscape - Jan 30, 2013.