HIV - NPEP

NPEP - Non Occupation Post Exposure Prophylaxis

Administering antiretrovirals to patients who have had a high risk exposure (usually men who have sex with men) can reduce the risk of transmission of HIV.  

NPEP Checklist 2018


Bendigo 

Bendigo ED is an access point for the statewide program coordinated by the Alfred hospital.  Patients presenting will usually be triaged to fast track but be aware of privacy issues.

Patients can access a website called Get NPEP to advice on how and where to get NPEP http://getpep.info.  They will be directed to Bendigo ED if they are nearby. 

RIsk Assessment

Medical staff will make a clinical assessment using the table on page 6 of current guidelines and the initial consultation form (which you will fax to the number on the form).

Further clinical information about risk and guidelines can be found on the Alfred NPEP site.

Contacting the NPEP Program

If you would like to discuss any complex cases please don't hesitate to call the NPEP program.  Contact 1800 889 887 once you have done your assessment to get advice.  This is staffed 24 hours Fri, Sat & Sun.  Mid week its manned 0800 to midnight.  If its after hours midweek and you need advice about when to dispense NPEP then you can call the Alfred infectious dieases registrar 90762000.

Medications

You will need to dispense the medication if risk assessment indicates to do so.  Dispense 7 day NPEP starter pack of either 2 or 3 drugs.

          2 drug NPEP = Lamivudine 300mg oral daily + Tenofivir 300mg oral daily

          3 drug NPEP = Lamivudine 300mg oral daily + Tenofivir 300mg oral daily + Dolutegravir 50mg daily

Write the patient's name, date and your name (the prescriber) on the label of each medication.

The medication packs are supplied by the NPEP program to pharmacy.  There is one pack stationed in ED Fast Track (in a plastic bag in the medication cupboard under "N") and a reserve pack in the Pharmacy After Hours Cupboard.  The NPEP program couriers a pack when one is used in is used in business hours.  If directed, dispense the medication with the medication information sheet.  If there is no packs available the oncall pharmacy can access further anti retrovirals.

Please fax the consultation form both to Alfred NPEP and also to Pharmacy - the fax to pharmacy will trigger them to restock the ED NPEP medications.

 

Baseline Blood Tests

HIV serology, Gepatitis B (HBsAG, HBsAB, HBcAB), Hep C serology, Syphilis serology, U+E with copies to followup doctor.

 

FOLLOWUP

Needs to be done within 7 days to get the remaining 21 days of medications.

For patients near Bendigo Golden City Medical Clinic will provide followup - Dr Regina Clark and Dr John Togno have an interest in following these patients up.

Patients from elsewhere can see there GP or contact the NPEP program for followup.