Post-exposure prophylaxis (PEP) is the treatment given after being exposed to a harmful pathogen or substance. If you Google post-exposure prophylaxis, you will mainly read about this treatment in relation to HIV. Post-exposure prophylaxis is also used with rabies, the hepatitis viruses, Clostridium tetani (tetanus) and Anthrax. The goal of PEP is to prevent the sickness to develop after exposure, so before the person gets sick. The treatment does not work after the sickness has already manifested.

The human immunodeficiency virus (HIV) is perhaps the pathogenic agent that is most talked about as far as post-exposure prophylaxis is concerned. This is because HIV is a lifelong and incurable disease, and it is also one of the most feared infections.

Types of PEP

Occupational post-exposure prophylaxis and non-occupational post-exposure prophylaxis are the two types of post-exposure prophylaxis.

Occupational post-exposure prophylaxis (oPEP) is the treatment given to health workers who accidentally got exposed to a harmful agent in their line of duty. Needlestick injury is one such type of accidental exposure. HIV and hepatitis infections are easily transmitted through needlestick injuries. Non-occupational post-exposure prophylaxis is the treatment given to someone who was exposed to an infection in a non-work environment such as in sexual intercourse or drug use.

Who is Eligible for PEP?

Post-exposure prophylaxis, as highlighted earlier, prevents the body to develop the sickness from the pathogenic agent. It is not used for curative purposes. Persons eligible for PEP include:

  • Those who sustained a needlestick injury at their place of work.
  • Persons who have sex with persons from areas that are HIV-endemic.
  • Persons who are at a risk of contracting infectious agents like HIV and hepatitis B through sexual intercourse. Men who have sex with men have a much higher incidence of HIV and hepatitis B.
  • Babies born to HIV positive and hepatitis B infected mothers. The babies are immediately given PEP, before any other routine medication recommended for babies is administered to them.
  • Persons who inject drugs intravenously and who share needles or drug preparation equipment.
  • Sexually abused/assaulted persons.

When Is A Post-exposure Prophylaxis Given?

Post-exposure prophylaxis is most ideally given within 72 hours of exposure to the infection. In possible rabies infection, within 24 hours. Anything after the said time recommended is not effective.

Post-exposure prophylaxis is given as an emergency treatment for eligible persons. It is pertinent to quickly report any case of needlestick injury and sexual abuse/assault to a healthcare professional over the phone or in the hospital. In the case of an exposure to HIV, the prophylaxis is expected to be taken for up to 28 days after which an HIV test will be carried out to ascertain the body's level of response to the treatment. Post-exposure prophylaxis is only useful with HIV if a test is still negative.

When taken correctly as prescribed by a health professional, post-exposure prophylaxis is very effective in preventing infections from pathogens. Taking PEP demands practicing safe sex while using the preventive medication. Condoms have to be used correctly for every sexual intercourse, while still on the post-exposure prophylaxis, until tested free from the infection.