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HIV Post-Exposure Prophylaxis — RACP Adult Medicine MCQ

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ModerateInfectious DiseasesHIV Post-Exposure ProphylaxisRACP Adult Medicine

A 40-year-old woman who is a healthcare worker sustains a needlestick injury from a patient with known HIV (viral load detectable, on ART but non-adherent). She presents within 1 hour of the injury. Her HIV test is negative. What is the most appropriate management?

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Correct answer: C — Triple-agent PEP (tenofovir + emtricitabine + dolutegravir)

High-risk needlestick injury (hollow bore needle, HIV-positive source with detectable viral load) within 72 hours requires triple-agent PEP. Current Australian guidelines recommend tenofovir/emtricitabine + dolutegravir for 28 days. PEP should be commenced as soon as possible (ideally within 1–2 hours). Baseline testing and follow-up at 6 weeks and 3 months.

Reference: ASHM – 2024 – HIV PEP Guidelines; Australian National Guidelines for PEP