PATIENT INFORMATION

Post Exposure Prophylaxis

What is Post Exposure Prophylaxis (PEP) for HIV?

Post exposure prophylaxis (PEP) for HIV (Human Immunodeficiency Virus) is oral medication taken to reduce the risk of contracting HIV within 72 hours of coming in contact with the virus. It should be started as soon as possible and is over 80% effective if taken regularly for a period of 4weeks.

Sexual Health clinics and Accident & Emergency can provide PEP.

HIV

Human Immunodeficiency Virus is a virus that weakens the immune system, which is what protects you from diseases.

HIV can be contracted via blood or genital fluids if these fluids come in contact with mucous membranes (e.g. in the vagina, anus or on the penis during sex) or damaged tissue (e.g. open wounds, bleeding gums), or via a needle puncture (e.g. a needlestick injury or injecting drug use).

It is possible to live with the virus and have no symptoms till the immune system is so weak it becomes susceptible to a number of life threatening diseases. At this point, AIDS (Acquired Immune Deficiency Syndrome) is said to have developed and can be fatal.

Therefore, it is much better to be tested and aware of one’s HIV status and if positive, medication can be started to suppress the virus and maintain a good immune system and healthy life.

PEP Medication

Commonly the drugs Truvada and Raltegravir are used:

  • Truvada (a combination on Tenofovir and Emtricitabine):

1 tablet to be taken once a day (with or without food)

  • Raltegravir: 1 tablet to be taken twice a day (with or without food)

PLEASE NOTE: Antacids, anti-indigestion remedies, vitamins and multivitamins should be avoided as they stop PEP from working. If you have to take these please separate by 6hours.

Possible Side Effects

Truvada can rarely affect the kidneys and make them leak protein. This will not usually cause symptoms. As a precaution, your urine will be checked using a dip stick test when you come for your 2 week follow up.

Raltegravir can rarely cause muscle ache, especially in the lower legs. If you experience this, please contact the clinic.

(Everyone reacts differently to medication. Please read the manufacturer’s leaflet that comes with the medication.)

Missed tablets

PEP works best if there is a constant amount of the drugs in your body. It is really important that you take them regularly. Never take a double dose to make up for missing one

  • Missed Truvada:

If it has been less than 12 hours, take the tablet as soon as possible. Then take the next dose as usual.

If it has been more than 12 hours, then do not take the missed dose. Wait and take the next dose at your usual time.

  • Missed Raltegravir:

If it has been less than 8 hours, take the tablet as soon as possible. Then take the next dose as usual.

If it has been more than 8 hours, then do not take the missed dose. Wait and take the next dose at your usual time.

Safe Sex

Even though HIV can take up to 3months to be detectable by a blood test, it can still be passed on earlier. We therefore advise you abstain from sex during this time or use condoms. This will also protect you against other sexually transmitted illnesses like Chlamydia and Hepatitis. Other STIs can also lie symptomless for a long period of time. This is why we advise you get tested STIs other than HIV.

Testing Timetable

At your first visit we will offer:

  • a blood test for blood borne viruses (BBV) - HIV, Syphilis, Hepatitis B and/or Hepatitis C
  • a blood test for kidney (U&E) and liver function (LFTs)
  • a urine dip to check your urine for protein
  • a sexual health screen
  • a pregnancy test (PT) if applicable, can be repeated 3 weeks later
  • vaccination against Hepatitis B if applicable
  • we generally advise regular 3 to 6monthly STI and BBV screens

Testing timetable summary and dates

This can be filled in with you at the sexual health clinic.

Dates / U&Es/ LFTs / PT / HIV test / Hep B status / Hep B immu-nity / HepC / STI screen / Urine dip
Baseline
Date: / Can have 1st Hepatitis B vaccination if indicated:
Date: / PEP started
2 weeks later
Date: / 2nd Hepatitis B vaccination:
Only if base-linenot normal / X / X / X / X / X
4 weeks later
Date: / PEP finished
3rd Hepatitis B vaccination:
X / X / X / X / X / X / X
8weeks - if started on Hep B vaccination
Date: / X / X / X / X
12 weeks
Date: / X / X / X / X
24 weeks
Date: / X / X / X / X / X / If
Indi-cated / X / X
4th (final) Hepatitis B vaccination:

If you’ve been given a 5 day pack in Accident & Emergency (A&E)

If you have already been seen in A&E, it is likely they have already done some baseline tests. If not, don’t worry we can do the tests (and vaccination) in clinic. It is important you start taking the medication immediately. Please attend our clinic as soon as possible after your A&E visit and bring what’s left of your PEP medication with you.

Important Tips

  • It is important to still use condoms as these not only protect against HIV but other STIs and unwanted pregnancies.
  • It is strongly advised not to take herbal remedies or recreational drugs while on PEP due to the risk of drug interactions. You can check for drug interactions on
  • It is important you complete the whole course of PEP to improve its efficacy.
  • It is important to attend your follow up appointments especially your 12 week HIV blood test.
  • Please store medication at room temperature and keep out of reach of children.
  • Please inform the prescribing doctor or nurse of any medication you are taking.

ANY CONDITION SPECIFIC DANGER SIGNALS TO LOOK OUT FOR:

  • If you develop flu-like symptoms, e.g. a rash, muscle aches, sore throat, fever or swollen glands, please contact the sexual health clinic. These are all symptoms of the common cold, but it is important to discuss this with a nurse or doctor as it may be a sign of HIV acquisition.

Further Information

  • Truvada leaflet:
  • Raltegravir leaflet:
  • To check for HIV drug interactions:
  • Terence Higgins Trust:

During your contact with us, it is important that you are happy with your care and treatment. Please speak to a member of staff and/or the ward/departmentIf Sister/Charge Nurse if you have questions or concerns.

MATRON

A Matron is also available during the hours of 9am to 5pm Monday to Friday.During these periods, ward/department staff can contact Matron to arrange to meet with you. Out of hours, a Senior Nurse can be contacted via the ward/department to deal with any concerns you may have.

INFECTION CONTROL REQUEST

Preventing infections is a crucial partof our patients’ care. To ensure that our standards remain high our staff have regular infection prevention and control training and their practice is monitored in the workplace. We ask patients and visitors to assist us in preventing infections by cleaning their hands at regular intervals and informing staff of areas within the hospital that appear soiled.

As a patient there may be times that you are unsure whether a staff member has cleaned their hands; if in doubt please ask the staff member and they will be only too happy to put your mind at ease by cleaning their hands so that you can see them.

CONTACT INFORMATION IF YOU ARE WORRIED ABOUT YOUR CONDITION

  • Nurse or doctor at Sefton Sexual Health Services. Phone: 01704 513303. For opening times, please see
  • Your GP

OTHER USEFUL TELEPHONE NUMBERS/CONTACTS:

NHS 111

Stop Smoking Helpline (Sefton) – 0300 100 1000

Stop Smoking Helpline (West Lancashire) – 0800 328 6297

Please call 01704 704714 if you need this leaflet in an alternative format

Southport andOrmskirkHospital NHS Trust

Ormskirk & DistrictGeneralHospital

Wigan Road, Ormskirk, L39 2AZ

Tel: (01695) 577111

Southport & FormbyDistrictGeneralHospital

Town Lane, Kew, Southport, PR8 6PN

Tel: (01704) 547471

FOR APPOINTMENTS

Telephone (01704) 513303

Author:Zana Ladipo

Ref:17/14

Version:1

Produced: May 2017

Review Date:May 2020