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  • Print publication year: 2005
  • Online publication date: February 2010

24 - HIV postexposure prophylaxis for pediatric patients

from Part III - Antiretroviral therapy

Summary

Background

Postexposure prophylaxis (PEP) refers to the timely administration of antiretroviral (ARV) chemoprophylaxis to reduce the probability of becoming infected with HIV after an acute well-defined exposure. PEP can be categorized as occupational (oPEP) or non-occupational (nPEP). This chapter summarizes the epidemiology of various types of HIV exposures, including strategies for preventing these exposures and recent findings from animal and human studies which lend support for the use of oPEP and nPEP, reviews current United States Public Health Service (USPHS) recommendations for oPEP and nPEP, and addresses special considerations regarding nPEP for pediatric patients. Prevention of mother-to-child transmission (MTCT) of HIV is addressed in Chapter 8. The USPHS oPEP recommendations continue to recommend a two-tiered system of three ARVs vs two ARVs, depending on level of risk. The chapter highlights a change in the USPHS nPEP recommendations, which now emphasize the importance of using three-drug regimens, when feasible, for all exposures that warrant PEP in order to be consistent with the current standard of care regarding treatment of established HIV infection.

Occupational postexposure prophylaxis

For the purposes of this chapter, healthcare personnel (HCP) are defined as persons whose activities involve contact with patients or with patients' blood or other body fluids in a healthcare, laboratory, or public-safety setting [1].

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