Post-exposure prophylaxis (PEP) is treatment that can be used after possible exposure to Hepatitis B or HIV virus through sex, injecting drug equipment or injury such as needle stick injury. PEP is given to decrease the risk of infection with HIV or Hepatitis B virus. It does not reduce the risk of other sexually transmissible infections or infection with blood-borne viruses including Hepatitis C.
The best ways to avoid infection with HIV, Hepatitis B virus and other blood-borne and sexually transmissible infections include:
Post-exposure prophylaxis can be used in emergency situations where there has been a failure in usual precautions and there may be a risk of exposure to HIV and hepatitis B. Examples are:
If there has been an incident in which a person may have been exposed to HIV or Hepatitis B virus, that person should go to their local doctor, family planning clinic, sexual health clinic or local public hospital as soon as possible, preferably within 24 hours. If the delay is longer than three days, PEP is not effective.
It is natural for people in this situation to be very anxious. The treating doctor will provide information and support.
The doctor will assess the risk of exposure. This depends on:
At that first visit to the doctor or clinic, blood tests will be done. There are no tests which can show whether a person has been infected with HIV or any other infection from an exposure within the past couple of days. Those first blood tests are done to check whether that person has any sign of previously existing infection with HIV, and whether there is any sign of infection with or immunity to Hepatitis B virus.
Tests will be repeated at six weeks, three months and six months. After infection with HIV (and Hepatitis B) it may take some time for the infection to show up in blood tests. This is called the window period. The window period for HIV is three months and for Hepatitis B it is six months. A person cannot be sure there is no infection until tests at those times are completed.
If there is a definite risk of exposure to HIV, PEP for HIV would be recommended. If the treating doctor or health worker is not familiar with PEP, they can contact doctors who are specialists in HIV medicine or infectious diseases.
If there is a risk of exposure to Hepatitis B virus, PEP for hepatitis B would be recommended.
If there is a risk of pregnancy, women should ask the doctor or health worker about emergency contraception.
The risk of infection with Hepatitis C virus and sexually transmissible infections should also be considered. Tests can be done if necessary.
Until tests and follow-up are completed:
HIV
PEP for HIV consists of a combination of drugs taken for one month. These drugs have been shown to reduce the risk of infection following accidental exposure to HIV. They do not protect against repeated or long term exposure to HIV. Common side effects include diarrhoea, nausea, loss of appetite and headaches.
Hepatitis B
Blood tests can show whether a person has immunity to Hepatitis B virus. This could be from past infection or from immunisation. If there is no immunity, an injection of immunoglobulin can be given. This provides protection against recent accidental exposure to Hepatitis B virus. Hepatitis B immunoglobulin does not provide long term protection against Hepatitis B virus.
Hepatitis B vaccination is recommended as safe and effective long term protection against Hepatitis B virus. It is given as three injections over six to 12 months.
If you want more information about post-exposure prophylaxis, you can talk to:
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© The State of Queensland (Queensland Health) 2008.
