Page 244 - ATP-P 11th Ed

HIV POST EXPOSURE PROPHYLAXIS PROTOCOL

SPECIAL CONSIDERATIONS
1. Initiation of the highly active antiretroviral therapy (HAART) should ideally
occur within 2 hours of exposure, but still has some effect up to 72 hours after
exposure.
2. Antiretrovirals have a significant side-effect profile, including nausea, vomiting,
SECTION 2 3. Obtain a sample of the source’s blood for HIV and hepatitis testing, if possible.
and diarrhea.
4. Use of a commercially available Rapid HIV Test Kit that uses either an oral
specimen or whole blood is recommended for source testing to determine if
HAART therapy should be initiated. This should occur within 1–2 hours. The
test requires 20–40 minutes to obtain results. The use of one of the following
FDA approved Rapid HIV Test kits is recommended (as of 2009):
a. whole blood, plasma or oral fluid:
i. OraQuick Advance Rapid HIV 1/2 Antibody Test
b. whole blood or serum/plasma:
®
i. Uni-Gold Recombigen HIV Test
™
®
ii. Clearview HIV 1/2 STAT-PAK ®
iii. Clearview Complete HIV 1/2 Test
®

High Risk Exposures
1. Percutaneous injury (needle stick or other contaminated penetrating injury)
2. Exposure or exchange of body fluids with persons at high risk for HIV
3. Transfusion of blood products that have not undergone standard U.S. blood bank or
equivalent testing for transmissible diseases
4. When attempting to evaluate a high-risk exposure, take into account the source of
the bodily contamination. For example, blood from a fellow Soldier would fall into a
low risk category for exposure.
Management
1. Wash area with soap and water to clean area and minimize exposure.
2. Use a Rapid HIV Test Kit to determine if therapy should be initiated. In high risk situ-
ations, do not delay initiation of therapy if the test kit is not available. HIV PEP
should be started within 1–2 hours of exposure.

234 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 235