CDC Updates Post-Exposure Prophylaxis Recommendations for Occupational HIV Exposure
The Centers for Disease Control and Prevention (CDC) have released a report detailing two important changes affecting current post-exposure prophylaxis (PEP) recommendations for occupational HIV exposures:
- Lopinavir/ritonavir is no longer manufactured as 133 mg lopinavir/33 mg ritonavir capsules. Therefore, instead of the three capsules twice daily that were recommended for PEP, two 200 mg lopinavir/50 mg ritonavir tablets twice daily should now be prescribed.
- Nelfinavir should no longer be prescribed to pregnant women or women who may become pregnant. High levels of ethyl methanesulfonate (EMS), a known animal carcinogen, mutagen, and teratogen, have been found in nelfinavir manufactured in Europe.
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Researchers: Rate of Triple-Class Resistance Is Low
According to a recently published study of nearly 8,000 HIV-infected patients receiving antiretroviral therapy (ART), extensive triple-class virologic failure is only 9.2% after 10 years of ART, and may even be declining. (Triple-class virologic failure was defined by virologic failure of three subclasses of NRTIs, an NNRTI, and a ritonavir-boosted PI.)
The robustness of first-line therapies is particularly encouraging for areas where second- or third-line drugs are not readily available and are not expected to be for several years.
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