Question 4 - Nonoccupational Postexposure Prophylaxis Question Bank

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Nonoccupational Postexposure ProphylaxisQuestion 4/10

A 20-year-old cisgender man presents to the emergency room after a likely sexual exposure to HIV; he describes having condomless receptive anal intercourse approximately 12 hours ago with an anonymous male partner that he hooked up with through an online service. He thinks the anonymous partner has HIV but is not certain. This 20-year-old man has no known medical problems.

Based on the Nonoccupational PEP Guidelines, which one of the following antiretroviral regimens is a preferred regimen for nonoccupational postexposure prophylaxis (PEP)?

Raltegravir plus zidovudine-lamivudine

Dolutegravir-abacavir-lamivudine

Dolutegravir plus tenofovir DF-emtricitabine

Lopinavir-ritonavir plus tenofovir DF-emtricitabine

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Question Last Updated
September 20th, 2023

Table 1. **2016 CDC and HHS Guidelines for Nonoccupational Exposure to HIV**

Preferred and Alternative 28-Day Regimens for Nonoccupational HIV PEP^a,b
Adults and adolescents aged ≥13 years with normal renal function (creatinine clearance ≥60 mL/min), including pregnant people
Preferred Regimens: Raltegravir (400 mg twice daily) plus tenofovir DF-emtricitabine (300-200 mg once daily) Dolutegravir (50 mg once daily) plus tenofovir DF-emtricitabine (300-200 mg once daily) Alternative Regimen: Darunavir (800 mg once daily) plus ritonavir (100 mg once daily) plus tenofovir DF-emtricitabine (300-200 mg once daily)
Adults and adolescents aged ≥13 years with renal dysfunction (creatinine clearance ≤59 mL/min)⁺
Preferred Regimens: Raltegravir (400 mg twice daily) plus zidovudine (dose adjusted) plus lamivudine (dose adjusted) Dolutegravir (50 mg once daily) plus zidovudine (dose adjusted) plus lamivudine (dose adjusted) Alternative Regimen: Darunavir (800 mg once daily) plus ritonavir (100 mg once daily) plus zidovudine (dose adjusted) plus lamivudine (dose adjusted)
^aThese recommendations do not reflect current Food and Drug Administration-approved labeling for antiretroviral medications listed in this table. ^bRitonavir is used in clinical practice as a pharmacokinetic enhancer to increase the trough concentration and prolong the half-life of darunavir, lopinavir, and other protease inhibitors. Ritonavir is not counted as a drug directly active against HIV in the above “3-drug” regimens. ⁺The dose adjustments for zidovudine and lamivudine are made based on degree of renal function

Source:

Centers for Disease Control and Prevention: U.S. Department of Health and Human Services. Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, and Other Nonoccupational Exposure to HIV—United States, 2016. [CDC]

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Nonoccupational Postexposure ProphylaxisQuestion 4/10

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Based on the Nonoccupational PEP Guidelines, which one of the following antiretroviral regimens is a preferred regimen for nonoccupational postexposure prophylaxis (PEP)?

Preferred and Alternative 28-Day Regimens for Nonoccupational HIV PEPa,b

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Preferred and Alternative 28-Day Regimens for Nonoccupational HIV PEP^a,b