SPEAK OUT

HIV

Present suggestions on nonoccupational PEP in children. Please go to ww.hivpepregistry.org/pdf/ped/pep.pdf. If you have problems linking in, use the www.hivpepregistry.org website and then link onto the references at the bottom. The reference is entitled pediatric postexposure prophylaxis. Pages 309-311 provide age-specific suggestions. They need to be given within hours of the exposure.

In addition, although Nevirapine has been quite effective for reducing perinatal transmission, it's not really recommended for long term prophylaxis status post an exposure because of severe liver-related side effects seen among hospital workers who took it after occupational exposures. In the context of reducing mother to child transmission, a single 200 mg dose is given orally to the mother at onset of labor and a single 2 mg/kg oral dose is given to the infant at 48-72 hours. If the mother received NVP less than one hour prior to delivery, the infant should be given 2 mg/kg oral NVP as soon as possible after birth and again at 48-72 hours. It's been well tolerated in these situations. Although CDC has no data related to rape cases, one might extropolate from the perinatal situation to this situation and hypothesize that a single dose of NVP to the infant within a few hours of a high risk exposure might be beneficial in reducing transmission.

The CDC is in the process of updating the nonoccupational PEP guidelines and they should be going out for public comment soon, but it will be a while before they get published.