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TBL PEP PrEP
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TBL PEP PrEPHIV preventie
- Screening bloedproducten
- Educatie
- Laagdrempelig HIV testen
- 90-90-90 = Hierop is het TasP-concept (Treatment as Prevention) gebaseerd dat de
WHO in 2014 heeft uitgerold in een wereldwijde strategie onder de naam 90–90–90:
in 2020 moet 90 % van alle hiv-positieven zijn opgespoord, moet 90 % van deze
groep ook op cART zijn gezet en moet 90 % met deze cART daarmee ook volledige
virussuppressie hebben bereikt.
- Maar ook: Post en pre expositie profylaxe
Deel 1: casustiek PEP
PEP geef je bij
- Beroepsaccident (prikken, snijden)
- Niet-beroepsacidenten (seksueel onveilig gedrag bijv)
Wanneer is PEP nuttig?
- Transmissie risico vorm accident
- De virulentie van de bron (behandeld?)
- Therapietrouw —> hoeveelheid pillen, hoe vaak per dag, bijwerkingen
- Zo snel mogelijk, < 72 uur (effectiviteit)
- Risicogroep / risicogedrag
- Vrouwelijke sekswerkers
- IV drugs gebruik
- MSM
- Transgenders
- Seksueel gedrag (anaal hoog risico, vaginaal receptief hoog, vaginaal insertief laag)
- Perinatale expositie
Effectiviteit van PEP
- Zidovudine monotherapie bij prikaccidenten RR 80%
- Triple therapie bij zwangerschap: transmissie van 25-35% —> 1-2%
- Apenstudies: tot 72 uur zinvol, 28 dagen PEP
Risico op HIV transmissie
- Prikaccident: 0,3%
- Risico hoger bij:
- Diepe verwonding
- Naald gecontamineerd met bloed
- Arteriele / veneuze naald
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