TABLE 2 - Antiretroviral regimens for nonoccupational postexposure prophylaxis of HIV infection
Preferred regimens
NNRTI†-based Efavirenz‡ plus (lamivudine or emtricitabine) plus (zidovudine or tenofovir)
Protease inhibitor (PI)-based Lopinavir/ritonavir (co-formulated as Kaletra) plus (lamivudine or emtricitabine) plus zidovudine
Alternative regimens
NNRTI-based Efavirenz‡ plus (lamivudine or emtricitabine) plus abacavir or didanosine or stavudine§
PI-based Atazanavir plus (lamivudine or emtricitabine) plus (zidovudine or stavudine or abacavir or didanosine) or (tenofovir plus ritonavir [100 mg/day])
Fosamprenavir plus (lamivudine or emtricitabine) plus (zidovudine or stavudine) or (abacavir or tenofovir or didanosine)
Fosamprenavir/ritonavir¤ plus (lamivudine or emtricitabine) plus (zidovudine or stavudine or abacavir or tenofovir or didanosine)
Indinavir/ritonavir¤, º plus (lamivudine or emtricitabine) plus (zidovudine or stavudine or abacavir or tenofovir or didanosine)
Lopinavir/ritonavir (co-formulated as Kaletra) plus (lamivudine or emtricitabine) plus (stavudine or abacavir or tenofovir or didanosine)
Nelfinavir plus (lamivudine or emtricitabine) plus (zidovudine or stavudine or abacavir or tenofovir or didanosine)
Saquinavir (hgc† or sgc†)/ritonavir‡ plus (lamivudine or emtricitabine) plus (zidovudine or stavudine or abacavir or tenofovir or didanosine)
Triple NRTI Abacavir plus lamivudine plus zidovudine (only when an NNRTI- or PI-based regimen cannot or should not be used)
† NNRTI = non-nucleoside reverse transcriptase inhibitor; NRT1 = nucleoside reverse transcriptase inhibitor; sgc = soft-gel saquinavir capsule (Fortovase); hgc = hard-gel saquinavir capsule (Invirase).
‡ Efavirenz should be avoided in pregnant women and women of child bearing potential.
§ Higher incidence of lipoatrophy, hyperlipidemia. and mitochondrial toxicities associated with stavudine than with other NRTIs.
¤ Low-dose (100-400 mg) ritonavir. See Table 4 for doses used with specific PIs.
º Use of ritonavir with indinavir might increase risk for renal adverse events.
Source: U.S. Department of Health and Human Services. Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents, October 29, 2004 revision. Available at http://www.aidsinfo.nih.gov/guidelines/default_db2.asp?id=50. This document is updated periodically; refer to website for updated versions.
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