Post-exposure prophylaxis for HIV - Revision history

Aidan: /* Investigations */

2022-07-05T18:50:46Z

Investigations

← Older revision		Revision as of 18:50, 5 July 2022
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	\|		\|
	\|-		\|-
	\|[[HIV]] serology		\|[[HIV\|HIV]] serology
	\| style="text-align:center;" \|X		\| style="text-align:center;" \|X
	\| style="text-align:center;" \|X		\| style="text-align:center;" \|X

Aidan: /* Risk Assessment */

2021-03-10T13:38:31Z

Risk Assessment

← Older revision		Revision as of 13:38, 10 March 2021
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	\|-		\|-
	\| rowspan="2" \|substantial		\| rowspan="2" \|substantial
	\|HIV-positive with detectable viral load		\|HIV-positive with detectable viral load (100%)
	\|-		\|-
	\|HIV status unknown, but from a population with high prevalence such as MSM or PWID		\|HIV status unknown, but from a population with high prevalence such as MSM (~23%) or PWID (~13%)
	\|-		\|-
	\|low but nonzero		\|low but nonzero
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	\|-		\|-
	\| rowspan="3" \|negligible or none		\| rowspan="3" \|negligible or none
	\|confirmed HIV negative		\|confirmed HIV negative (0%)
	\|-		\|-
	\|HIV positive with confirmed viral load <40 copies/mL without known STI at time of exposure		\|HIV positive with confirmed viral load <40 copies/mL without known STI at time of exposure
	\|-		\|-
	\|HIV status unknown, in the general population		\|HIV status unknown, in the general population (0.25%)
	\|}

	{\| class="wikitable"
	\|+Estimated risk of HIV by population
	!Population
	!Risk
	\|-
	\|General population
	\|0.25%
	\|-
	\|Men who have sex with men
	\|23%
	\|-
	\|Person who injects drugs
	\|
	\|}		\|}

Aidan: /* Management */

2021-03-10T13:36:41Z

Management

← Older revision		Revision as of 13:36, 10 March 2021
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	\|-		\|-
	\|Blood on compromised skin		\|Blood on compromised skin
			\| align="center" \|—
			\|-
			\|Negligible
			\|Found needle
	\| align="center" \|—		\| align="center" \|—
	\|}		\|}

Aidan: /* Investigations */

2021-03-10T13:35:31Z

Investigations

← Older revision		Revision as of 13:35, 10 March 2021
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	\| style="text-align:center;" \|X		\| style="text-align:center;" \|X
	\| style="text-align:center;" \|X		\| style="text-align:center;" \|X
			\|
	\|}		\|}

Aidan: /* Management */

2021-03-10T13:35:07Z

Management

@@ Line 30: / Line 30: @@
 |-
 |HIV status unknown, in the general population
 |}
@@ Line 77: / Line 92: @@
 {| class="wikitable"
 !Risk of HIV-Positive Source
 !Risk From Exposure

Aidan: /* Risk Assessment */

2021-03-10T13:30:42Z

Risk Assessment

← Older revision		Revision as of 13:30, 10 March 2021
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	*If the source person is available and consents to testing, this can be done to more accurately risk stratify the exposure		*If the source person is available and consents to testing, this can be done to more accurately risk stratify the exposure
			*In general, prophylaxis is indicated if the estimated risk is '''greater than 0.1%'''

	{\| class="wikitable"		{\| class="wikitable"

Aidan: /* Risk Assessment */

2020-09-24T13:17:05Z

Risk Assessment

← Older revision		Revision as of 13:17, 24 September 2020
Line 30:		Line 30:
	\|HIV status unknown, in the general population		\|HIV status unknown, in the general population
	\|}		\|}

	{\| class="wikitable"		{\| class="wikitable"
	\|+Risk of HIV transmission per act by exposure type from an HIV-positive source		\|+Risk of HIV transmission per act by exposure type from an HIV-positive source
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	\|Blood on compromised skin		\|Blood on compromised skin
	\| align="center" \|—		\| align="center" \|—
	\|}~~<br />~~		\|}

	{\| class="wikitable"		{\| class="wikitable"
	!Risk of HIV-Positive Source		!Risk of HIV-Positive Source

Aidan at 13:16, 24 September 2020

2020-09-24T13:16:23Z

← Older revision		Revision as of 13:16, 24 September 2020
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	*Can be sexual or non-sexual; consensual or non-consensual; and heterosexual or homosexual		*Can be sexual or non-sexual; consensual or non-consensual; and heterosexual or homosexual
			*HIV does not survive very long outside of the human body, which is why a random needle in park, for example, is very low risk

	==Management==		==Management==

Aidan: /* Investigations */

2020-09-24T12:56:41Z

Investigations

← Older revision		Revision as of 12:56, 24 September 2020
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	\|-		\|-
	\|CBC		\|CBC
			\| style="text-align:center;" \|X
	\|X
	\|		\|
	\|		\|
	\|-		\|-
	\|ALT		\|ALT
			\| style="text-align:center;" \|X
	\|X
	\|		\|
	\|repeat at 2 weeks if abnormal		\|repeat at 2 weeks if abnormal
	\|-		\|-
	\|creatinine		\|creatinine
			\| style="text-align:center;" \|X
	\|X
	\|		\|
	\|repeat at 2 weeks if abnormal		\|repeat at 2 weeks if abnormal
	\|-		\|-
	\|[[Hepatitis A virus\|hepatitis A]] serology		\|[[Hepatitis A virus\|hepatitis A]] serology
			\| style="text-align:center;" \|X
	\|X
	\|		\|
	\|		\|
	\|-		\|-
	\|[[Hepatitis B virus\|hepatitis B]] serology		\|[[Hepatitis B virus\|hepatitis B]] serology
			\| style="text-align:center;" \|X
	\|X
	\|		\|
	\|includes HBsAb, HBsAg, and HBcAb		\|includes HBsAb, HBsAg, and HBcAb
	\|-		\|-
	\|pregnancy test		\|pregnancy test
			\| style="text-align:center;" \|X
	\|X
	\|		\|
	\|		\|
	\|-		\|-
	\|[[HIV]] serology		\|[[HIV]] serology
			\| style="text-align:center;" \|X
	\|X
			\| style="text-align:center;" \|X
	\|X
	\|repeat at 6 months if hepatitis C seroconversion		\|repeat at 6 months if hepatitis C seroconversion
	\|-		\|-
	\|[[hepatitis C]] serology		\|[[hepatitis C]] serology
			\| style="text-align:center;" \|X
	\|X
			\| style="text-align:center;" \|X
	\|X
	\|		\|
	\|-		\|-
	\|[[gonorrhea]] and [[chlamydia]]		\|[[gonorrhea]] and [[chlamydia]]
			\| style="text-align:center;" \|X
	\|X
			\| style="text-align:center;" \|X
	\|X
	\|urine, throat, and rectum, depending on reported sexual activity		\|urine, throat, and rectum, depending on reported sexual activity
	\|-		\|-
	\|[[syphilis]] serology		\|[[syphilis]] serology
			\| style="text-align:center;" \|X
	\|X
			\| style="text-align:center;" \|X
	\|X
	\|}		\|}

Aidan: /* Further Reading */

2020-09-24T10:18:46Z

Further Reading

← Older revision		Revision as of 10:18, 24 September 2020
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	*Can be sexual or non-sexual; consensual or non-consensual; and heterosexual or homosexual		*Can be sexual or non-sexual; consensual or non-consensual; and heterosexual or homosexual

	== Management ==		==Management==

	=== Risk Assessment ===		===Risk Assessment===

	* If the source person is available and consents to testing, this can be done to more accurately risk stratify the exposure		*If the source person is available and consents to testing, this can be done to more accurately risk stratify the exposure

	{\| class="wikitable"		{\| class="wikitable"
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	*Don't forget screening for [[Hepatitis A virus\|hepatitis A]], [[Hepatitis B virus\|hepatitis B]], [[Hepatitis C virus\|hepatitis C]], [[gonorrhea]], [[chlamydia]], and [[syphilis]]		*Don't forget screening for [[Hepatitis A virus\|hepatitis A]], [[Hepatitis B virus\|hepatitis B]], [[Hepatitis C virus\|hepatitis C]], [[gonorrhea]], [[chlamydia]], and [[syphilis]]

	=== Investigations ===		===Investigations===
	{\| class="wikitable"		{\| class="wikitable"
	!Investigation		!Investigation
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	==Further Reading==		==Further Reading==

	*~~Tan ''et al''. [https://doi.org/10.1503/cmaj.170494~~ Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis]. ''CMAJ'' 2017;189(47):e1448-e1458.		*Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis. ''CMAJ''. 2017;189(47):e1448-e1458. doi: [https://doi.org/10.1503/cmaj.170494 10.1503/cmaj.170494]

	[[Category:HIV]]		[[Category:HIV]]