A 19-year-old rape survivor is brought to hospital 30 hours after the assault. She is counselled regarding post-exposure prophylaxis against HIV. The CORRECT regimen advice is:
- A Start antiretroviral drugs immediately and continue for 28 days ✓
- B Wait for the 6-week HIV serology report before deciding on therapy
- C Start antiretroviral drugs and continue lifelong
- D Antiretroviral prophylaxis is useful only if started within 12 hours of exposure
Correct answer: A. Start antiretroviral drugs immediately and continue for 28 days
Explanation
HIV post-exposure prophylaxis after sexual assault should be started as early as possible and certainly within 72 hours of exposure, then continued for a full 28-day course with a three-drug regimen. Waiting for seroconversion defeats the purpose, since PEP must act before the virus establishes infection. Lifelong therapy is treatment of established infection, not prophylaxis, and the accepted window extends to 72 hours, not merely 12 hours.
Reference: The Essentials of Forensic Medicine and Toxicology, K.S. Narayan Reddy, 34th ed.
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Written and medically reviewed by the StethoPrep medical team.