HIV Post-Exposure Prophylaxis after Sharps or Splash Exposure (BASHH 2021)
Applies the 2021 UK (BASHH/BHIVA) recommendations on HIV post-exposure prophylaxis (PEP) after an occupational sharps or mucosal splash exposure, by source HIV status, type of exposure and time since exposure.
Score interpretation
Intact skin, HIV-negative source, splash from a source with an undetectable viral load, or more than 72 hours.
→ No PEP. Wound care (wash with soap and water; irrigate mucous membranes); document the exposure and decision; occupational health follow-up, including blood-borne virus testing where indicated.
Sharps injury from a source on effective ART with an undetectable viral load, or sharps / splash exposure from an untested source. From an untested source in a low-risk group PEP is not recommended.
→ Discuss urgently with occupational health or the infectious diseases / sexual health service. Seek prompt voluntary HIV testing of the source. Consider PEP only with an extenuating factor — e.g. a deep injury or injected blood from an untested source in a high-risk group (such as MSM or people who inject drugs).
Sharps or mucosal splash exposure from a source known to be HIV-positive with an unknown or detectable viral load.
→ Start PEP as soon as possible, preferably within 24 hours (not beyond 72 hours): first-line tenofovir disoproxil / emtricitabine plus raltegravir once daily for 28 days (BASHH/BHIVA 2021). Baseline HIV, hepatitis B and C serology, creatinine and ALT; occupational health follow-up; final HIV test at least 45 days after completing PEP.
Interpretation bands for the HIV PEP — Sharps / Splash. Apply clinical judgement and local guidance.
References
- Cresswell F, Asanati K, Bhagani S, et al. UK guideline for the use of HIV post-exposure prophylaxis 2021. HIV Med. 2022;23(5):494–545.
Related
Curated clinical cross-links plus same-class fallbacks.
- Palivizumab · RSV Prophylaxis — Monthly Monoclonal Antibody (High-Risk Infants)
- Enoxaparin (VTE Prophylaxis — Post-Surgery) · Low Molecular Weight Heparin (LMWH) — VTE Prophylaxis
- Rivaroxaban (Perioperative VTE Prophylaxis) · Direct Oral Anticoagulant — VTE Prophylaxis Post-Surgery
- Lisinopril (HFrEF / Post-MI) · ACE Inhibitor / HFrEF
- Colchicine (Pericarditis / Post-MI Inflammation) · Pericarditis / Coronary Inflammation
- Clopidogrel (ACS / Post-PCI) · Antiplatelet / ACS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.