HIV Post-Exposure Prophylaxis (PEP)
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Questions and Answers

What is the recommended duration of a course of PEP?

  • 14 days
  • 28 days (correct)
  • 21 days
  • 30 days

What is the goal of promoting the use of barrier protection during sexual encounters?

  • To prevent HIV transmission (correct)
  • To cure HIV
  • To treat HIV
  • To diagnose HIV

What is the recommended regimen for PEP?

  • 2-drug regimen involving an integrase inhibitor
  • 4-drug regimen involving a protease inhibitor
  • 5-drug regimen involving a non-nucleoside reverse transcriptase inhibitor
  • 3-drug regimen involving an integrase inhibitor (correct)

What is the time frame within which PEP should be started?

<p>As soon as possible, and no later than 72 h (C)</p> Signup and view all the answers

What is the concept that refers to the idea that people living with HIV who have undetectable viral loads are not infectious?

<p>Undetectable = Untransmittable (U=U) (D)</p> Signup and view all the answers

What is the first-line ART regimen for PEP?

<p>Tenofovir disoproxil, lamivudine, and dolutegravir (C)</p> Signup and view all the answers

What is the primary way that HIV can be spread to babies?

<p>Through breastfeeding by an infected mother (D)</p> Signup and view all the answers

What is the enzyme responsible for converting viral RNA into DNA during the HIV life cycle?

<p>Reverse transcriptase (C)</p> Signup and view all the answers

During which phase of HIV infection does the patient experience flu-like symptoms?

<p>Primary infection phase (D)</p> Signup and view all the answers

What is the purpose of the WHO clinical staging system?

<p>To classify patients into four hierarchical stages (D)</p> Signup and view all the answers

What is the result of the integration of viral DNA into the host DNA during the HIV life cycle?

<p>The creation of viral protein chains (A)</p> Signup and view all the answers

What is the average time it takes for an HIV infection to develop into AIDS?

<p>10 years (C)</p> Signup and view all the answers

What percentage of people living with HIV in SA are currently on treatment?

<p>70-75% (C)</p> Signup and view all the answers

What is the purpose of providing additional adherence support to people with HIV?

<p>To address difficulties with adherence to appointments or ART (D)</p> Signup and view all the answers

What is the risk of HIV transmission in a healthcare setting through percutaneous exposure?

<p>0.3% (B)</p> Signup and view all the answers

What is the purpose of UNAIDS 95:95:95 goals?

<p>To improve access to treatment and prevent HIV transmission (D)</p> Signup and view all the answers

What is the primary purpose of PrEP?

<p>To prevent HIV infection in high-risk individuals (A)</p> Signup and view all the answers

What is the administration of a short course of antiretroviral therapy to an HIV-negative person who has been exposed to HIV called?

<p>PEP (B)</p> Signup and view all the answers

Study Notes

Adherence to ART

  • Adherence to ART should be regularly assessed by self-report at every clinic visit.
  • People with HIV having difficulties with adherence to appointments or ART should be provided additional adherence support using a constructive, collaborative, non-judgmental, and problem-solving approach.

Treatment Goals

  • Only 70% to 75% of all people living with HIV in SA are currently on treatment.
  • UNAIDS 95:95:95 goals: 95% of all people with HIV know their status, 95% of those who know their status are on treatment, and 95% of those on treatment are virally suppressed.
  • SA's progress towards the UNAIDS goals: 94% (status), 79% (treatment), and 91% (virally suppressed).

Stigma, Discrimination, and Disclosure

  • Treatment as Prevention (TasP) approach emphasizes the importance of early treatment to reduce HIV transmission.
  • Pre-Exposure Prophylaxis (PrEP) is not intended for everyone, but for those at high risk of HIV infection.
  • PrEP does not replace traditional risk-reduction strategies.

Post-Exposure Prophylaxis (PEP)

  • PEP is a short course of antiretroviral therapy to prevent HIV acquisition after exposure.
  • PEP should be started as soon as possible, and no later than 72 hours, after exposure.
  • The global recommendation for PEP is a 3-drug regimen, including an integrase inhibitor, for 28 days.
  • Almost all PEP is now 28 days of first-line ART (TLD: tenofovir disoproxil, lamivudine, and dolutegravir).

HIV Transmission Prevention

  • Promote barrier protection (latex condoms and lubricant) during sexual encounters.
  • Effective use of PrEP can prevent HIV transmission.
  • Undetectable viral loads in serodiscordant sexual partners living with HIV (U=U) can prevent transmission.
  • Harm reduction practices in people who inject drugs (PWID) can also prevent transmission.
  • Strict adherence to universal precautions within the healthcare setting is essential.

Mother-Infant (Vertical) Transmission

  • HIV can be spread to babies born to, or breastfed by, mothers infected with the virus.
  • Prevention of Mother-To-Child Transmission (PMTCT) is a crucial aspect of HIV prevention.

Pathophysiology of HIV

  • HIV is a single-stranded RNA retrovirus that infects and replicates with CD4 cells (T helper cells).
  • The virus penetrates the host CD4 cell, empties its contents, and converts its RNA into DNA using reverse transcriptase.
  • The viral DNA is combined with the host DNA using the enzyme integrase.

Phases of HIV Infection

  • Primary infection: At seroconversion, the patient may experience flu-like symptoms, and CD4 levels fall in response to the initial, rapid replication of HIV.
  • Latent phase: The infection enters a latent phase, and the patient may initially be asymptomatic, but with CD4 levels falling and viral load increasing.
  • Chronic infection: The HIV infection can later become symptomatic and eventually develop into AIDS over an average of 10 years.

WHO Clinical Stages

  • The WHO system for adults classifies patients into one of four hierarchical clinical stages ranging from stage 1 (asymptomatic) to stage 4 (AIDS).

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Assess your knowledge of HIV post-exposure prophylaxis (PEP), a crucial emergency intervention for persons exposed to HIV. Learn about the recommended 3-drug regimen, duration of treatment, and more.

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