A 28 year old doctor is performing a caesarean section at a rural hospital in the Eastern Cape at 2am on a Saturday morning. She has “double-gloved”, but sustains a needle stick injury with a solid needle which causes a laceration of her skin. She knows that her patient is HIV-positive and has been on antiretroviral therapy (ART) for approximately two months. A recent viral load result is not available, and the healthcare worker (HCW) is not sure of the patient’s adherence. She completes the surgery and washes her hands thoroughly. A patient emergency arises in the ward, which she attends to, before going to the doctor in charge for advice.
The senior doctor advises the exposed HCW to take PEP
Question 1: The latest post-exposure prophylaxis (PEP) guidelines advise: