New updates to international guidelines on post-exposure prophylaxis (PEP) for HIV have been released, changing the approach to risk assessment, drug selection, and follow-up after possible exposure to the virus, particularly among healthcare workers.
This update replaces the guidelines that have been in place since 2013, taking into account the emergence of new antiretroviral drugs, current understanding of the window of detection by HIV tests, and new data on the risk of transmission if the source has an undetectable viral load.
The main changes concern the recommended drug regimens for PEP and the testing schedule after exposure to the virus. The new regimens include modern combinations of antiretroviral drugs that are better tolerated and more effective, and take into account experience with low transmission risk from people with undetectable viral loads. The recommendations also shorten the period of repeat HIV testing after possible exposure, simplifying the monitoring process. In most cases, routine laboratory testing for drug toxicity during PEP is excluded if the risk of complications is low and clinical monitoring is sufficient.
The updated document emphasizes that risk assessment should remain individualized, and experts should be consulted in complex situations. Despite changes in treatment regimens and monitoring logistics, the authors of the recommendations emphasize the preservation of basic principles: prevention in the workplace, timely reporting of incidents, prescription of PEP when indicated, and structured medical follow-up for individuals after potential exposure to HIV.