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Postexposure Prophylaxis

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1. Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis

Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis E1448 CMAJ | NOVEMBER 27, 2017 | VOLUME 189 | ISSUE 47 © 2017 Joule Inc. or its licensors N ew HIV infections occur every year in Canada, 1 highlighting the need for integrated prevention programs. Pre-exposure pro- phylaxis (PrEP) and nonoccupational postexposure prophy- laxis (nPEP) are two important strategies for preventing HIV that should be considered standard of care and implemented (...) as components of a comprehensive response to the epidemic. Pre-exposure prophylaxis is the use of certain antiretroviral medications by HIV-uninfected per- sons who are at high, ongoing risk of HIV acquisition, beginning before and continuing after potential HIV exposures. Postexposure prophy- laxis (PEP) involves 28 days of antiretroviral medications immediately after a specific HIV exposure, and is “nonoccupational” (nPEP) when used after sexual and injection drug use exposures, rather than acci- dental

2017 CPG Infobase

3. Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis (PubMed)

Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis 29941442 2018 11 14 1488-2329 190 25 2018 Jun 25 CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne CMAJ Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis. E782 10.1503/cmaj.180718 eng Journal Article Published Erratum Canada CMAJ 9711805 0820-3946 CMAJ. 2017 Nov 27;189(47):E1448-E1458 29180384 2018 6 27 6 0 2018 6

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2018 CMAJ : Canadian Medical Association Journal

4. Reducing Hematologic Toxicity With Short Course Postexposure Prophylaxis With Zidovudine for HIV-1 Exposed Infants With Low Transmission Risk. (PubMed)

Reducing Hematologic Toxicity With Short Course Postexposure Prophylaxis With Zidovudine for HIV-1 Exposed Infants With Low Transmission Risk. Using retrospectively collected data from 383 infants born to HIV-1-infected mothers receiving antiretroviral therapy, we compared transmission rates and hematologic toxicity between infants receiving 2-week (short course) versus longer duration zidovudine postexposure prophylaxis. Short course resulted in lower hematologic toxicity without evidence

2019 Pediatric Infectious Dsease Journal

5. Updates on HIV nonoccupational postexposure prophylaxis. (PubMed)

Updates on HIV nonoccupational postexposure prophylaxis. Adolescents and young adults continue to contribute to new HIV infections despite improved antiretroviral regimens and HIV preexposure and postexposure prophylaxis (PrEP and PEP). Knowledge about nonoccupational HIV PEP (nPEP) is relevant and important for all pediatricians as adolescents present under a variety of circumstances disclosing past sexual activity.nPEP is effective in preventing HIV infection, and newer regimens have been

2019 Current Opinion in Pediatrics

6. Simplification of Rabies Postexposure Prophylaxis: A New 2-Visit Intradermal Vaccine Regimen. (PubMed)

Simplification of Rabies Postexposure Prophylaxis: A New 2-Visit Intradermal Vaccine Regimen. A 2-visit multiple-site intradermal (ID) vaccine protocol would be the most economical, immunogenic, and practicable regimen for postexposure rabies prophylaxis (PEP) in clinics seeing few patients a month. This regimen with an additional day 28 dose is now recommended by the WHO. The difficulties surrounding ID rabies vaccination have hindered progress in provision of prophylaxis, especially in rural (...) Asia and Africa. Although the latest WHO recommendations include 1-week ID postexposure vaccine regimens, these are unlikely to prove economical where rabies vaccination is presently unavailable. The new protocol uses a whole vial of vaccine divided between 4-site ID on the first day and half a vial at 2-site ID on day 7. Gavi has recently approved support for rabies PEP. This 2-visit 4-site ID regimen, with or without a day 28 dose, should be considered for implementation in this remarkable new

2019 American Journal of Tropical Medicine & Hygiene

7. Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis (PubMed)

Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis 29180384 2017 12 20 2018 11 13 1488-2329 189 47 2017 11 27 CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne CMAJ Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis. E1448-E1458 10.1503/cmaj.170494 Tan Darrell H S DHS Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; BC Centre (...) .; CATIE (Canadian AIDS Treatment Information Exchange) (Rogers), Toronto, Ont. Biomedical HIV Prevention Working Group of the CIHR Canadian HIV Trials Network eng Journal Article Practice Guideline Canada CMAJ 9711805 0820-3946 0 Anti-HIV Agents AIM IM CMAJ. 2018 Jun 25;190(25):E782 29941442 Anti-HIV Agents administration & dosage therapeutic use Canada HIV Infections prevention & control Humans Post-Exposure Prophylaxis methods standards Pre-Exposure Prophylaxis methods standards Competing interests

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2017 CMAJ : Canadian Medical Association Journal

8. Postexposure Prophylaxis After Possible Anthrax Exposure: Adherence and Adverse Events (PubMed)

Postexposure Prophylaxis After Possible Anthrax Exposure: Adherence and Adverse Events Anthrax postexposure prophylaxis (PEP) was recommended to 42 people after a laboratory incident that involved potential aerosolization of Bacillus anthracis spores in 2 laboratories at the Centers for Disease Control and Prevention in 2014. At least 31 (74%) individuals who initiated PEP did not complete either the recommended 60 days of antimicrobial therapy or the 3-dose vaccine regimen. Among the 29 (...) that discontinued the antimicrobial component of PEP, most (38%) individuals discontinued PEP because of their low perceived risk of infection; 9 (31%) individuals discontinued prophylaxis due to PEP-related minor adverse events, and 10% cited both low risk and adverse events as their reason for discontinuation. Most minor adverse events reported were gastrointestinal complaints, and none required medical attention. Individuals taking ciprofloxacin were twice as likely (RR = 2.02, 95% CI = 1.1-3.6

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2016 Health security

9. Systematic Review and Meta-analysis of Postexposure Prophylaxis for Crimean-Congo Hemorrhagic Fever Virus among Healthcare Workers. (PubMed)

Systematic Review and Meta-analysis of Postexposure Prophylaxis for Crimean-Congo Hemorrhagic Fever Virus among Healthcare Workers. We performed a systematic review and meta-analysis on the effectiveness of ribavirin use for the prevention of infection and death of healthcare workers exposed to patients with Crimean-Congo hemorrhagic fever virus (CCHFV) infection. Splashes with blood or bodily fluids (odds ratio [OR] 4.2), being a nurse or physician (OR 2.1), and treating patients who died from (...) CCHFV infection (OR 3.8) were associated with healthcare workers acquiring CCHFV infection; 7% of the workers who received postexposure prophylaxis (PEP) with ribavirin and 89% of those who did not became infected. PEP with ribavirin reduced the odds of infection (OR 0.01, 95% CI 0-0.03), and ribavirin use <48 hours after symptom onset reduced the odds of death (OR 0.03, 95% CI 0-0.58). The odds of death increased 2.4-fold every day without ribavirin treatment. Ribavirin should be recommended as PEP

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2018 Emerging Infectious Diseases

10. Failure of Postexposure Prophylaxis in a Patient Given Rabies Vaccine Intramuscularly in the Gluteus Muscle, Himachal Pradesh, India (PubMed)

Failure of Postexposure Prophylaxis in a Patient Given Rabies Vaccine Intramuscularly in the Gluteus Muscle, Himachal Pradesh, India A 48-year-old male was bitten by a dog on the forehead and on the RIGHT side of left eyebrow on November 26, 2017, at 2 pm. The patient was immediately rushed to a nearby private hospital where an MBBS doctor gave him immediate wound wash with soap and water and prescribed five doses of rabies vaccine intramuscularly (IM). Since the patient weight was 60 kg, he

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2018 Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine

11. Case Report: A Common Source Outbreak of Anisakidosis in the United States and Postexposure Prophylaxis of Family Collaterals. (PubMed)

Case Report: A Common Source Outbreak of Anisakidosis in the United States and Postexposure Prophylaxis of Family Collaterals. We present a case of intussusception with complete small bowel obstruction caused by intestinal anisakidosis requiring surgical resection. A 30-year-old man presented with acute onset of severe abdominal pain 3 days after eating home-cured salmon gravlax. Despite surgery, the patient developed recurrent abdominal pain on two occasions with evidence of continued (...) inflammation proximal to the surgical anastomosis. He was then treated with albendazole and prednisone, and symptoms improved. A decision was made to prophylactically treat two asymptomatic family members who also consumed home-cured gravlax with albendazole, resulting in one individual passing an intact Anisakis worm in her stool. We suggest that albendazole therapy could be considered as a therapy for continued symptoms of anisakidosis and postexposure prophylaxis of Anisakis larvae ingestion from

2018 American Journal of Tropical Medicine & Hygiene

12. PEPtalk2: results of a pilot randomised controlled trial to compare VZIG and aciclovir as postexposure prophylaxis (PEP) against chickenpox in children with cancer. (PubMed)

PEPtalk2: results of a pilot randomised controlled trial to compare VZIG and aciclovir as postexposure prophylaxis (PEP) against chickenpox in children with cancer. To determine the likely rate of patient randomisation and to facilitate sample size calculation for a full-scale phase III trial of varicella zoster immunoglobulin (VZIG) and aciclovir as postexposure prophylaxis against chickenpox in children with cancer.Multicentre pilot randomised controlled trial of VZIG and oral

2018 Archives of Disease in Childhood

13. Rabies Postexposure Prophylaxis (PEP) Noncompletion After Dog Bites: Estimating the Unseen to Meet the Needs of the Underserved. (PubMed)

Rabies Postexposure Prophylaxis (PEP) Noncompletion After Dog Bites: Estimating the Unseen to Meet the Needs of the Underserved. Postexposure prophylaxis (PEP) prevents human rabies and is accessible in Cambodia principally in Phnom Penh, the capital. Timely, affordable access to PEP is a challenge for the mainly rural population. We aimed to identify districts independently associated with PEP noncompletion to position frontline vaccination centers. We analyzed the 2009-2013 database

2017 American Journal of Epidemiology

14. The Priority of Administering HIV Postexposure Prophylaxis in Cases of Sexual Assault in an Emergency Department. (PubMed)

The Priority of Administering HIV Postexposure Prophylaxis in Cases of Sexual Assault in an Emergency Department. Contracting the human immunodeficiency virus (HIV) is a genuine concern for sexually assaulted patients. Emergency departments are a place where sexually assaulted patients seek care, including treatment to prevent HIV. Prompt administration of nonoccupational postexposure prophylaxis is essential because of the time-sensitive nature of the medications. Quality improvement measures (...) at an urban hospital revealed delays in administration of postexposure prophylaxis to these patients.A forensic simulation course and checklist was developed for emergency departments to improve care for sexually assaulted patients. Data used for analysis included time of administration of nonoccupational postexposure medication and length of stay before and after intervention with the simulation course and checklist. Points of measurement included student t-test to assess any significant differences

2017 Journal of Emergency Nursing

15. A Meta-Analysis of HIV Postexposure Prophylaxis Among Sexually Assaulted Patients in the United States.

A Meta-Analysis of HIV Postexposure Prophylaxis Among Sexually Assaulted Patients in the United States. Sexual assault (SA) is a major public health problem that leaves patients at risk for HIV. The gold standard of medical treatment for SA patients includes prophylactic treatment to prevent HIV. A meta-analysis was conducted and examined the rates of nonoccupational postexposure prophylaxis (n-PEP) offered to, accepted, and completed by SA patients who presented to emergency departments

2017 The Journal of the Association of Nurses in AIDS Care : JANAC

16. Notes from the Field: Postexposure Prophylaxis for Rabies After Consumption of a Prepackaged Salad Containing a Bat Carcass — Florida, 2017 (PubMed)

Notes from the Field: Postexposure Prophylaxis for Rabies After Consumption of a Prepackaged Salad Containing a Bat Carcass — Florida, 2017 29073123 2018 12 11 2018 12 11 1545-861X 66 42 2017 Oct 27 MMWR. Morbidity and mortality weekly report MMWR Morb. Mortal. Wkly. Rep. Notes from the Field: Postexposure Prophylaxis for Rabies After Consumption of a Prepackaged Salad Containing a Bat Carcass - Florida, 2017. 1154-1155 10.15585/mmwr.mm6642a7 Krishnasamy Vikram V Mauldin Matthew R MR Wise (...) Matthew E ME Wallace Ryan R Whitlock Laura L Basler Colin C Morgan Clint C Grissom Dana D Worley Sherry S Stanek Danielle D DeMent Jamie J Yager Pamela P Carson William W Condori Rene E RE Nakazawa Yoshinori Y Walker Claire C Li Yu Y Wynens Christopher C Wellman Allison A Ellison James J Pieracci Emily E eng Journal Article 2017 10 27 United States MMWR Morb Mortal Wkly Rep 7802429 0149-2195 IM Animals Chiroptera Florida Food Contamination Humans Post-Exposure Prophylaxis Product Recalls

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2017 MMWR. Morbidity and mortality weekly report

17. Targeting Vaccine-Induced Extrafollicular Pathway of B Cell Differentiation Improves Rabies Postexposure Prophylaxis (PubMed)

Targeting Vaccine-Induced Extrafollicular Pathway of B Cell Differentiation Improves Rabies Postexposure Prophylaxis Vaccine-induced B cells differentiate along two pathways. The follicular pathway gives rise to germinal centers (GCs) that can take weeks to fully develop. The extrafollicular pathway gives rise to short-lived plasma cells (PCs) that can rapidly secrete protective antibodies within days of vaccination. Rabies virus (RABV) postexposure prophylaxis (PEP) requires rapid vaccine

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2017 Journal of virology

18. Differentiating Nonoccupational Postexposure Prophylaxis Seroconverters and Non-Seroconverters in a Community-Based Clinic in Los Angeles, California (PubMed)

Differentiating Nonoccupational Postexposure Prophylaxis Seroconverters and Non-Seroconverters in a Community-Based Clinic in Los Angeles, California Nonoccupational postexposure prophylaxis (nPEP) is a 28-day regimen of antiretroviral medications taken within 72 hours of human immunodeficiency virus (HIV) exposure to prevent HIV acquisition. Although nPEP has been recommended since 1998, few studies have analyzed the characteristics that distinguish nPEP failures (seroconverters) and successes (...) -exposure, 8 self-reported only condom-protected sex subsequent to the initial exposure, and 2 reported abstinence since the exposure. In multivariable analyses, seroconverters were more likely than non-seroconverters to report methamphetamine use, incomplete medication adherence, and nPEP initiation later in the 72-hour window.Nonoccupational postexposure prophylaxis is an important emergency tool for HIV prevention. Our findings corroborate that timing of the initial nPEP dose is an important

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2017 Open forum infectious diseases

19. Sexual Assault and HIV Postexposure Prophylaxis at an Urban African Hospital (PubMed)

Sexual Assault and HIV Postexposure Prophylaxis at an Urban African Hospital Antiretroviral postexposure prophylaxis (PEP) may be underutilized in sexual assault cases in Kenya. This study evaluated the characteristics of survivors of sexual violence attending the Gender-Based Violence Recovery Center (GBVRC) at the Kenyatta National Hospital and reviewed the uptake, adherence, and outcomes of those initiated on PEP. In a retrospective cohort, data from charts of the assaulted seen at the GBVRC

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2017 AIDS patient care and STDs

20. Rabies postexposure prophylaxis in returned injured travelers from france, australia, and new zealand: a retrospective study. (PubMed)

Rabies postexposure prophylaxis in returned injured travelers from france, australia, and new zealand: a retrospective study. There is little published information available describing rabies pre- and postexposure prophylaxis (PEP) in tourists returning to their home country and seeking care for animal-associated injuries, especially those associated with a rabies risk.We analyzed 261 travelers seeking care on returning to their home country following an animal-related injury acquired abroad

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2017 Journal of Travel Medicine

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