By vgreene, 29 September, 2016 Weigh risks benefits of nPEP depending on type of exposure1 r o preexisting HIV 2 if indicated start 3 drug ARV nPEP regimen w o delay 2 monitor labs provide additional support
By vgreene, 29 September, 2016 ✓syphilis serology,14 chlamydia/gonorrhea NAAT,15 & pregnancy tests16 at baseline, then 4-6wk after sexual exposure & prescribe appropriate prophylaxis17
By vgreene, 29 September, 2016 Counsel on effective risk redux behaviors;12 consider PrEP at conclusion of nPEP if pt at risk for frequent exposure13
By vgreene, 29 September, 2016 If source is found to have drug resistance or contraindication to any preferred or alternative ARVs, seek consultation w/ HIV specialist11
By vgreene, 29 September, 2016 Prescribe entire 28-day course of nPEP;9 counsel on expected adverse drug reactions & prescribe prophylactic antiemetics10
By vgreene, 29 September, 2016 Measure AST/ALT at baseline, 4-6wk after exposure for regimens using TDF/FTC, RAL, or DTG, & throughout duration of tx as necessary for all regimens
By vgreene, 29 September, 2016 Measure SCr & estimate CrCl at baseline to guide selection of regimen & 4-6wk after exposure for regimens using TDF/FTC, RAL, or DTG
By vgreene, 29 September, 2016 Test source for HIV w/ rapid combined Ag/Ab test (or Ab test, if Ag/Ab test unavailable)3 & arrange for source to have clinical eval visit to determine risk of transmission, if possible1
By vgreene, 29 September, 2016 Perform rapid combined Ag/Ab HIV test (or Ab test, if Ag/Ab test unavailable)3-5 at baseline, then 4-6wk, 3mo, & 6mo;6 obtain HBV serology & HCV Ab at baseline & 6mo7,8 after any exposure
