Last Updated: June 2023
People taking PrEP as prescribed would generally not be eligible for PEP. However, those at risk of HIV acquisition taking PrEP may present for PEP in the context of suboptimal adherence to PrEP.103 Clinical104 and pharmacokinetic data101,105,106 provide good evidence of levels of adherence to PrEP required to effectively prevent HIV acquisition via anal and …
All patients presenting for PEP should be assessed for HBV (see Table 4). HBV-negative individuals Individuals with evidence of previous immunity to HBV (HBsAb ≥ 10 IU ever documented following complete vaccination course, or past cleared infection who are immunocompetent) require no further follow-up Non-immune people (anti-HBc and HBsAb and negative) require HBV immunisation and …
For all people presenting for PEP following a sexual exposure, refer to Table 4. Although a two-week PEP visit is not generally recommended following sexual exposures, an approximately 5% prevalence of new infections has been reported at two weeks, which were not detected on baseline testing.80,81 The following recommendations regarding STI testing are recommended for …
There is no current evidence to support any mode of PEP in preventing HCV acquisition following exposure to HCV.82 People presenting for PEP who may be at risk of HCV, either from prior risk exposures or from the risk exposure which prompted the presentation for HIV PEP, include: people who have shared needles and other …
In pregnancy The risk of HIV acquisition is increased and the viraemia that occurs during HIV seroconversion leads to an increased risk of intrauterine HIV transmission.86 Timely specialist consultation is recommended, however PEP should not be delayed or withheld in people who are pregnant. If three-drug PEP is indicated either dolutegravir 50 mg daily or …
Patients who sustain wounds or abrasions should have their tetanus status assessed and be offered immunisation as indicated. For further information, refer to the Australian Immunisation Handbook.
Table 2 details when PEP is indicated and which regimen to use (two-drug versus three-drug) for potential sexual and non-sexual exposures to HIV. A comprehensive risk assessment should inform the decision to initiate PEP and be made on a case-by-case basis. Situations with greater uncertainty or complexity (including known or suspected antiretroviral resistance in the …
Key recommendations PEP should be initiated as soon as possible and started no later than 72 hours after the exposure, ideally within 24 hours. The complete 28-day course of PEP should generally be prescribed and taken daily. A five-seven day PEP starter pack remains an option for emergency department presentations. In rural and remote settings …
Key recommendations The recommended first-line two-drug regimen is co-formulated tenofovir disoproxil and emtricitabine. There is no evidence to support the greater efficacy of three- over two-drug regimens, although we continue to recommend three-drug regimens in certain situations based on evidence that a higher number of drugs or combination of drug classes has historically achieved better …
For two-drug PEP, the following is not generally recommended: zidovudine. Co-formulated tenofovir disoproxil and emtricitabine is better tolerated.25 For three-drug PEP regimens, the following are not generally recommended: boosted regimens containing ritonavir or cobicistat due to the potential for drug-drug interactions with multiple prescription and over-the-counter medications (refer to Liverpool HIV Drug Interactions checker website) …
These guidelines are pending endorsement by the Blood Borne Viruses and Sexually Transmitted Infections Standing Committee (BBVSS).
Funded By: The Australian Government Department of Health
Disclaimer: Whilst the Australian Department of Health provides financial assistance to ASHM Health, the material contained in this resource produced by us should not be taken to represent the views of the Australian Department of Health.
The content of this resource is the sole responsibility of ASHM Health.
We acknowledge that ASHM Health offices are located on the land of the Gadigal peoples of the Eora Nation (Sydney Office) and the Turrbal and Jagera/Yuggera peoples (Brisbane Office) who are the Traditional Owners of the lands where both offices are situated. We pay our respects to Elders past and present.
ABN 48 264 545 457 | CFN 17788
Copyright © 2023 ASHM Health