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24 - HIV postexposure prophylaxis for pediatric patients

from Part III - Antiretroviral therapy

Published online by Cambridge University Press:  03 February 2010

By
Kenneth L. Dominguez
Edited by
Steven L. Zeichner  and
Jennifer S. Read
Kenneth L. Dominguez
Affiliation:
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Steven L. Zeichner
Affiliation:
National Cancer Institute, Bethesda, Maryland
Jennifer S. Read
Affiliation:
National Cancer Institute, Bethesda, Maryland
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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].

Type
Chapter
Information
Textbook of Pediatric HIV Care , pp. 384 - 410
Publisher: Cambridge University Press
Print publication year: 2005

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