Sofortmaßnahmen This figure shows the proportions of patients with HIV-1 RNA <50 copies/mL at Week 48 grouped according to baseline viral tropism. Although.

Präsentation zum Thema: "Sofortmaßnahmen This figure shows the proportions of patients with HIV-1 RNA <50 copies/mL at Week 48 grouped according to baseline viral tropism. Although."—  Präsentation transkript:

1 Sofortmaßnahmen This figure shows the proportions of patients with HIV-1 RNA <50 copies/mL at Week 48 grouped according to baseline viral tropism. Although the study was designed to include only patients with R5 virus, 25 (3.5%) had a dual mixed tropism result at baseline (the right hand bars). For 24 patients their viral tropism results changed from R5 at screening to D/M at baseline. One patient had virus assigned as D/M at screening was included in error. For patients with R5 virus at baseline there was no difference between treatment arms in the percentage of patients with HIV-1 RNA <50 copies/mL (shown on the left). There was a reduced response in patients with Dual/Mixed virus at baseline in efavirenz treatment arm compared to those with R5 virus (compare red bars). Of the 14 patients in the maraviroc treatment arm with D/M virus at baseline, very few achieved a response by week 48. Deutsch-Österreichische Leitlinien zur Postexpositionellen Prophylaxe der HIV-Infektion, 2013

2 Risiko für eine HIV-Übertragung nach Art der Exposition dargestellt im Verhältnis zum Durchschnitt
This figure shows the proportions of patients with HIV-1 RNA <50 copies/mL at Week 48 grouped according to baseline viral tropism. Although the study was designed to include only patients with R5 virus, 25 (3.5%) had a dual mixed tropism result at baseline (the right hand bars). For 24 patients their viral tropism results changed from R5 at screening to D/M at baseline. One patient had virus assigned as D/M at screening was included in error. For patients with R5 virus at baseline there was no difference between treatment arms in the percentage of patients with HIV-1 RNA <50 copies/mL (shown on the left). There was a reduced response in patients with Dual/Mixed virus at baseline in efavirenz treatment arm compared to those with R5 virus (compare red bars). Of the 14 patients in the maraviroc treatment arm with D/M virus at baseline, very few achieved a response by week 48. Deutsch-Österreichische Leitlinien zur Postexpositionellen Prophylaxe der HIV-Infektion, 2013

3 Indikation zur HIV-PEP bei beruflicher HIV-Exposition (Indexperson HIV-positiv)
This figure shows the proportions of patients with HIV-1 RNA <50 copies/mL at Week 48 grouped according to baseline viral tropism. Although the study was designed to include only patients with R5 virus, 25 (3.5%) had a dual mixed tropism result at baseline (the right hand bars). For 24 patients their viral tropism results changed from R5 at screening to D/M at baseline. One patient had virus assigned as D/M at screening was included in error. For patients with R5 virus at baseline there was no difference between treatment arms in the percentage of patients with HIV-1 RNA <50 copies/mL (shown on the left). There was a reduced response in patients with Dual/Mixed virus at baseline in efavirenz treatment arm compared to those with R5 virus (compare red bars). Of the 14 patients in the maraviroc treatment arm with D/M virus at baseline, very few achieved a response by week 48. Deutsch-Österreichische Leitlinien zur Postexpositionellen Prophylaxe der HIV-Infektion, 2013

4 Risikowahrscheinlichkeit für die HIV-Übertragung°
This figure shows the proportions of patients with HIV-1 RNA <50 copies/mL at Week 48 grouped according to baseline viral tropism. Although the study was designed to include only patients with R5 virus, 25 (3.5%) had a dual mixed tropism result at baseline (the right hand bars). For 24 patients their viral tropism results changed from R5 at screening to D/M at baseline. One patient had virus assigned as D/M at screening was included in error. For patients with R5 virus at baseline there was no difference between treatment arms in the percentage of patients with HIV-1 RNA <50 copies/mL (shown on the left). There was a reduced response in patients with Dual/Mixed virus at baseline in efavirenz treatment arm compared to those with R5 virus (compare red bars). Of the 14 patients in the maraviroc treatment arm with D/M virus at baseline, very few achieved a response by week 48. ° die angegebenen Zahlenwerte geben lediglich grobe Anhaltspunkte * Seroinzidenzstudie bei homosexuellen Männern in US-amerikanischen Großstädten # Partnerstudien bei serodiskordanten Paaren (überwiegend heterosexuell) Deutsch-Österreichische Leitlinien zur Postexpositionellen Prophylaxe der HIV-Infektion, 2013

5 Hierarchie von Infektionswahrscheinlichkeiten für die HIV-Übertragung
This figure shows the proportions of patients with HIV-1 RNA <50 copies/mL at Week 48 grouped according to baseline viral tropism. Although the study was designed to include only patients with R5 virus, 25 (3.5%) had a dual mixed tropism result at baseline (the right hand bars). For 24 patients their viral tropism results changed from R5 at screening to D/M at baseline. One patient had virus assigned as D/M at screening was included in error. For patients with R5 virus at baseline there was no difference between treatment arms in the percentage of patients with HIV-1 RNA <50 copies/mL (shown on the left). There was a reduced response in patients with Dual/Mixed virus at baseline in efavirenz treatment arm compared to those with R5 virus (compare red bars). Of the 14 patients in the maraviroc treatment arm with D/M virus at baseline, very few achieved a response by week 48. Deutsch-Österreichische Leitlinien zur Postexpositionellen Prophylaxe der HIV-Infektion, 2013

6 Indikation zur HIV-PEP bei nicht-beruflicher HIV-Exposition Teil 1
This figure shows the proportions of patients with HIV-1 RNA <50 copies/mL at Week 48 grouped according to baseline viral tropism. Although the study was designed to include only patients with R5 virus, 25 (3.5%) had a dual mixed tropism result at baseline (the right hand bars). For 24 patients their viral tropism results changed from R5 at screening to D/M at baseline. One patient had virus assigned as D/M at screening was included in error. For patients with R5 virus at baseline there was no difference between treatment arms in the percentage of patients with HIV-1 RNA <50 copies/mL (shown on the left). There was a reduced response in patients with Dual/Mixed virus at baseline in efavirenz treatment arm compared to those with R5 virus (compare red bars). Of the 14 patients in the maraviroc treatment arm with D/M virus at baseline, very few achieved a response by week 48. Deutsch-Österreichische Leitlinien zur Postexpositionellen Prophylaxe der HIV-Infektion, 2013

7 Indikation zur HIV-PEP bei nicht-beruflicher HIV-Exposition Teil 2
This figure shows the proportions of patients with HIV-1 RNA <50 copies/mL at Week 48 grouped according to baseline viral tropism. Although the study was designed to include only patients with R5 virus, 25 (3.5%) had a dual mixed tropism result at baseline (the right hand bars). For 24 patients their viral tropism results changed from R5 at screening to D/M at baseline. One patient had virus assigned as D/M at screening was included in error. For patients with R5 virus at baseline there was no difference between treatment arms in the percentage of patients with HIV-1 RNA <50 copies/mL (shown on the left). There was a reduced response in patients with Dual/Mixed virus at baseline in efavirenz treatment arm compared to those with R5 virus (compare red bars). Of the 14 patients in the maraviroc treatment arm with D/M virus at baseline, very few achieved a response by week 48. Deutsch-Österreichische Leitlinien zur Postexpositionellen Prophylaxe der HIV-Infektion, 2013

8 Indikation zur HIV-PEP bei nicht-beruflicher HIV-Exposition Teil 3
Deutsch-Österreichische Leitlinien zur Postexpositionellen Prophylaxe der HIV-Infektion, 2013

9 Indikation zur HIV-PEP bei nicht-beruflicher HIV-Exposition Teil 4
Deutsch-Österreichische Leitlinien zur Postexpositionellen Prophylaxe der HIV-Infektion, 2013

10 Empfehlung zu PEP-Medikamenten
Standardprophylaxe: Isentress 1 Tablette zweimal täglich plus Truvada1 Tablette einmal täglich über Tage Deutsch-Österreichische Leitlinien zur Postexpositionellen Prophylaxe der HIV-Infektion, 2013

11 Dosierung und wesentliche unerwünschte Wirkung (auch bei Schwangerschaft) von antiretroviralen Medikamenten, die für eine PEP empfohlen wurden Deutsch-Österreichische Leitlinien zur Postexpositionellen Prophylaxe der HIV-Infektion, 2013

12 Empfohlene Basis- und Kontrolluntersuchungen
° falls Person bekannt, aber Infektionsstatus unklar, Einwilligung erforderlich, ggf. Einsatz eines Schnelltestes ^ bei ausreichendem Impfschutz des Verletzten (AntiHBs>100 IE/ml innerhalb der letzten 10 Jahre) ist eine Testung auf HBsAg nicht erforderlich – ansonsten Impfung empfohlen * falls indiziert/ falls Exposition vorlag ** Kontrollen, falls gleichzeitig eine HCV-Exposition vorlag 1 Behandlungsanamnese mit antiretroviralen Medikamenten (Abschätzung der Resistenzsituation) 2 Einnahme anderer Medikamente? (cave! Wechselwirkungen) Verträglichkeit der PEP? Deutsch-Österreichische Leitlinien zur Postexpositionellen Prophylaxe der HIV-Infektion, 2013