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Case 5: Nonoccupational Exposure to HIV

You answered:

A Antiviral PEP should not be recommended in this case because the source patient recently had an HIV RNA level less than 50 copies/ml.

This answer is incorrect. Studies have demonstrated that HIV RNA levels in plasma and genital secretions do not correlate perfectly. Thus, although the source patient recently had an undetectable plasma HIV RNA level, this does not ensure that the HIV RNA level in his semen is undetectable. In addition, the HIV RNA was obtained approximately 8 weeks prior, which does not guarantee that his current plasma HIV RNA level is less than 50 copies/ml.

Choose another answer:

B Nevirapine (Viramune) should not be used as part of an antiviral PEP regimen after sexual exposure to HIV.
C The 2005 DHHS guidelines for antiviral PEP after sexual exposure to HIV recommend less aggressive antiretroviral regimens than those used for occupational PEP exposure, because all sexual exposures carry a markedly lower risk of HIV transmission than do percutaneous exposures to HIV.
D Studies have shown that offering PEP in this setting will lead to an increase in unsafe sexual behavior.

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