One of your staff nurse had a deep prick from the needle used to inject an HIV positive individual. What is the treatment regime that should be staed in her/him? Note that drug resistance was suspected in the HIV patient. rn
**Core Concept**
The treatment of occupational exposure to HIV involves the administration of antiretroviral medications to prevent the development of HIV infection. The choice of regimen depends on the type of exposure, the HIV viral load of the source patient, and the presence of antiretroviral resistance.
**Why the Correct Answer is Right**
The recommended treatment for post-exposure prophylaxis (PEP) in occupational exposure to HIV involves a combination of antiretroviral drugs. Given the suspected drug resistance in the HIV patient, a regimen that includes a combination of drugs with a different resistance profile is necessary. The preferred regimen for PEP in such cases is a combination of tenofovir disoproxil fumarate (TDF), emtricitabine (FTC), and raltegravir (RAL). TDF and FTC have a synergistic effect and are effective against a wide range of HIV strains, while RAL is a potent integrase inhibitor that is less likely to be affected by resistance.
**Why Each Wrong Option is Incorrect**
**Option A:** This option may include a regimen that is not suitable for PEP or may not address the issue of suspected drug resistance.
**Option B:** This option may not include a combination of drugs or may not be effective against a wide range of HIV strains.
**Option C:** This option may include a regimen that is not recommended for PEP or may not be suitable for occupational exposure to HIV.
**Clinical Pearl / High-Yield Fact**
It is essential to initiate PEP within 72 hours of exposure to HIV, as the effectiveness of the regimen decreases with time. Additionally, a baseline HIV test should be performed on the exposed individual, and follow-up tests should be conducted at 6 weeks, 3 months, and 6 months after the exposure to determine if HIV infection has occurred.
**Correct Answer: D. Tenofovir disoproxil fumarate (TDF), emtricitabine (FTC), and raltegravir (RAL)**