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Needle-Stick HIV PEP — FRCA Final MCQ

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EasyAnaesthetic Equipment & SafetyNeedle-Stick HIV PEPFRCA Final

A 30-year-old woman (ASA I, 55 kg) presents with a needle-stick injury from a known HIV-positive patient. She is anxious and asks about post-exposure prophylaxis (PEP). According to current UK guidelines, within what time frame should PEP ideally be commenced?

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Correct answer: A — Within 1 hour of exposure

UK guidelines (BASHH/BHIVA) recommend that HIV post-exposure prophylaxis should be started as soon as possible after exposure, ideally within 1 hour. Efficacy decreases with delay and PEP is not recommended after 72 hours. A 28-day course of three antiretroviral drugs is prescribed. Risk assessment should consider the source patient's viral load, the nature of the exposure (hollow-bore needle highest risk), and depth of injury. Baseline and follow-up HIV testing of the recipient is required.

Reference: BASHH/BHIVA – 2022 – PEP guidelines; PHE – 2021 – Eye of the needle surveillance