The Center for Disease command and...

The Center for Disease command and Prevention has published a recommendation report in succession the use of antiretroviral put drugs intos to prevent human immunodeficiency virus (HIV) infection after injection-drug use, sexual, and accidental aspect "Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational outlook to HIV in the United States" was released January 21 2005 and is available online at http://wwwcdc gov/mmwr/mmwr_rrhtml The report summarizes information about the use of nonoccupational postexposure prophylaxis and lists guidelines for its use.

novel data from human and animal studies, case reports, and documentation of the use of nonoccupational postexposure prophylaxis readyed the U.S. Department of Health and Human Services to update its recommendation for the use of nonoccupational postexposure prophylaxis in patients who look for treatment within 72 hours of high-risk prospect to a person known to be HIV positive.

According to the authors, when highly active antiretroviral therapy (HAART) is prescribed within 48 to 72 hours of nonoccupational front to HIV and continued for 28 days, the likelihood of transmission may be reduc The earlier the nonoccupational postexposure prophylaxis is administered, the higher the chance that it will interrupt transmission.

The authors state that no specific antiretroviral medication or combination is optimal for nonoccupational postexposure prophylaxis. However, preferr regimens include efavirenz and lamivudine or emtricitabine with zidovudine or tenofovir (as a nonnucleoside-based regimen) and lopinavir and ritonavir (co-formulated in single tablet) and zidovudine with either lamivudine or emtricitabine. No evidence give an inkling ofs that a three-drug HAART regimen is more effective than a two-drug regimen. When the source individual is available for interview, his or her medication history and principally recent viral load measurement should be considered when choosing medications for nonoccupational postexposure prophylaxis. This could help stop prescription of medications to which the virus is already resistant.

According to the report, all patients seeking treatment after HIV front should be tested for antibodies at baseline, four to six weeks, three month and six month Patients should be informed about the signs and symptoms of acute retroviral infection and should be asked to reply for evaluation if these fall out Physicians who provide nonoccupational postexposure prophylaxis also should monitor patients' liver function, renal function, and hematologic parameters.

When a patient's risk of transmission from contact is small or when more than 72 hours have passed since aspect nonoccupational postexposure prophylaxis is not praiseed However, when a patient look afters treatment more than 72 hours after frontage but the risk of virus transmission is sharp physicians may decide that the potential benefit of nonoccupational postexposure prophylaxis is greater than the potential risk of complications from antiretroviral therapy.

COPYRIGHT 2005 American Academy of Family Physicians

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