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How effective is post-exposure prophylaxis?
Jul 12, 1999

What if there is a risk of expoure, the likelihood to be cured by the cocktail if taken within the first 24 hours, before it is penetrating the lymph glands? Is it close to 100%. What are the rates of sucess reported in the studies? I did read the e-mails connetcted to it but is there an evaluation of the success. How many unrses still showed up positive after taking the cocktail as opposed to the rates before the cocktail was available. Would you give the cocktail to somebody who had cuts and somebody touched him with precum?

Response from Mr. Sowadsky

Thank you for your question. Post-Exposure Prophylaxis (PEP) after a high risk occupational exposure, has been found to reduce the infection rate by approximately 80% (depending on the study). PEP is recommended for high risk occupational exposures to blood and other high risk body fluids, from a person known to be infected with HIV, or known to be at very high risk for HIV. For example PEP would generally be recommended for a deep needle stick injury with exposure to the blood of a known HIV positive patient immediately after the needle was used. Although the use of PEP can significantly reduce the risk of infection under these circumstances, some healthcare workers still became infected despite using PEP (even though they correctly followed the recommended treatment guidelines) So using PEP will significantly reduce the risk of infection, but it will not eliminate the risk of infection. Because there are numerous variables that can determine if a person becomes infected with HIV after an occupational exposure (for example how much blood a person was exposed to, the viral load of the source patient, how deep a needle stick was, luck, etc.), nobody can statistically predict an individuals risk of infection ahead of time for every type of exposure. For more information on PEP for occupational exposures, read the following CDC report: Public Health Service Guidelines for the Management of Health-Care Worker Exposures to HIV and Recommendations for Postexposure Prophylaxis.

PEP is generally not recommended for low risk exposures (occupational or sexual). For example, the use of PEP is generally not recommended for exposure to pre-cum getting on a persons hand (since the chances of infection this way are unlikely).

The use of PEP may be considered for certain high risk sexual exposures. An example of a high risk sexual exposure would be unprotected anal intercourse with ejaculation from a known HIV positive patient. Because the use of PEP for sexual exposures is still being evaluated, the rate of success for PEP after a high risk sexual exposure is still unknown For more information on PEP for sexual exposures, read the article Post-Exposure Prophylaxis (PEP) For Sexual Exposures.

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).



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