Paper II — 2024 December (Supplementary) (2019 Scheme) — Q14
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Paper II
2024 December (Supplementary) (2019 Scheme) · 100 marks · 180 min
Question
Write briefly on post-exposure prophylaxis of HIV infection after a needlestick injury.
Q144 marksShort Answers
Answer
Post-exposure prophylaxis (PEP) is antiretroviral therapy started after a significant exposure to HIV (needlestick/sharps injury, mucous membrane or non-intact skin exposure to blood/body fluids, or sexual exposure), aiming to prevent established infection before it can take hold.
Timing: most effective when started as soon as possible, ideally within hours, and no later than 72 hours after exposure — efficacy falls progressively the longer initiation is delayed. Continued for 28 days.
Regimen: a combination of three antiretroviral drugs — commonly two NRTIs plus an integrase inhibitor (e.g. Tenofovir + Emtricitabine + Dolutegravir) — the same combination-therapy resistance-prevention logic as standard HIV treatment, never a single agent.
Immediate first-aid at the time of injury (before PEP drugs are even started): washing the area with soap and water (or flushing mucous membranes with water/saline), without aggressive scrubbing or caustic agents (which can increase local tissue damage), plus prompt reporting for risk assessment (source patient’s HIV status if known, exposure severity) — this determines whether PEP is actually indicated, since PEP carries its own real adverse-effect burden and is not given automatically for every exposure regardless of assessed risk.
