http://www.emanet.org/page.cfm?pageid=46

DH Website PEP guidance: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_088185

A case–control study conducted by the US Centers for

Disease Control and Prevention concluded that the

administration of zidovudine prophylaxis to health care

workers occupationally exposed to HIV was associated with

an 81% reduction in the risk for occupationally acquired

HIV infection (9).

zzFive cases of HIV seroconversion in UK health care

workers have been documented; four occurred in

or before 1993, only one of whom received PEP

(zidovudine monotherapy). The most recent case

was in 1999, when seroconversion occurred despite

combination PEP (18).

2.3 para 28:

Results from animal studies suggest that HIV PEP

is most likely to be efficacious if started within the hour.

45. PEP is most likely to be effective when initiated as soon as

possible (within hours, and certainly within 48–72 hours of

exposure), and continued for at least 28 days. It should be

noted that the evidence base on which these conclusions

are based is limited (see Annex H for a summary of the

HIV post-exposure prophylaxis

evidence). Therefore, PEP should be commenced as soon as

possible after exposure, allowing for careful risk assessment,

ideally within an hour. PEP is generally not recommended

beyond 72 hours post-exposure.

Tracy

Tracy Huguenel, RGN, SCPHN (OH)
Deputy Head of Occupational Health
01268 524900 Ext 3591
Fax 01268 534127
email: [log in to unmask]
www.basildonandthurrock.nhs.uk

From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of JANE COOMBS
Sent: 24 May 2011 15:17
To: [log in to unmask]
Subject: [OCC-HEALTH] Time for PEP

Hi

I hope someone can help me?

When I worked in the NHS some years ago, we had an flow chart for post exposure prophylaxis which said that PEP had to be given within so many hours of a needlestick injury. I think, if I remember rightly, it was 2 hours for the best possible result. In fact, we labelled it as a true emergency in OH terms.

I have now searched the green book, and WHO and find that the recommendation is now 'as soon as possible but within 72 hours'. Is this correct? Would appreciate some advice.

Thanks in anticipation

Jane
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