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HIV — SCE Infectious Diseases MCQ

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EasyHIV MedicineHIVSCE Infectious Diseases

A 33-year-old healthcare worker in a London hospital sustains a needlestick injury from a hollow-bore needle used on a known HIV-positive patient. The source patient's viral load is 85,000 copies/mL. The healthcare worker presents within 1 hour of the injury. What is the recommended post-exposure prophylaxis regimen and duration?

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Correct answer: D — Tenofovir DF/Emtricitabine plus Dolutegravir for 28 days

BHIVA/BASHH 2021 PEP guidelines recommend a 28-day course of Tenofovir DF/Emtricitabine plus a third agent. Dolutegravir has replaced Raltegravir as the preferred third agent due to once-daily dosing and improved tolerability. PEP should be initiated as soon as possible, ideally within 1 hour and no later than 72 hours post-exposure. This is a significant exposure (hollow-bore needle, high source viral load) warranting PEP.

Reference: BHIVA/BASHH 2021 – Guidelines on the use of HIV post-exposure prophylaxis; UKHSA 2022 – PEP guidance