A nurse sustains a hollow-bore needlestick injury while drawing blood from a patient with known HIV infection (source viral load 150,000 copies/mL). She reports immediately within 1 hour. What is the correct post-exposure prophylaxis plan?
- A Tenofovir disoproxil fumarate plus emtricitabine plus a third agent such as dolutegravir, started now and continued for 28 days ✓
- B Zidovudine alone for 7 days
- C Triple-drug prophylaxis deferred until the 6-week HIV test result
- D Two-drug prophylaxis for 3 months regardless of source viral load
Correct answer: A. Tenofovir disoproxil fumarate plus emtricitabine plus a third agent such as dolutegravir, started now and continued for 28 days
Explanation
Occupational exposure from a high-viral-load source warrants a three-drug regimen, typically tenofovir plus emtricitabine with an integrase inhibitor such as dolutegravir or raltegravir, begun as soon as possible and always within 72 hours, continued for 28 days. Zidovudine monotherapy is obsolete, waiting for serology forfeits the window in which post-exposure prophylaxis works, and three months is the duration for pre-exposure prophylaxis, not occupational PEP.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.