PrEP - Revision history

Maram.Ghiti@anthonynolan.org at 16:36, 19 December 2024

2024-12-19T16:36:20Z

Maram.Ghiti@anthonynolan.org: /* Acceptability at CT / Work-Up */

2024-12-19T16:29:53Z

Acceptability at CT / Work-Up

← Older revision		Revision as of 16:29, 19 December 2024
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	Donors should not be asked to stop PrEP to donate. The health and well-being of the donor is our top priority, and PrEP significantly reduces the risk of HIV transmission.		Donors should not be asked to stop PrEP to donate. The health and well-being of the donor is our top priority, and PrEP significantly reduces the risk of HIV transmission.

	Guidelines around oral PrEP have recently changed. Instead of a three-month deferral period, current guidance is to inform the TC of the PrEP and it is their discretion on whether a three month deferral period is required. If the TC feels that the risks of delaying the donation outweigh the risks of a false negative HIV result, then the deferral period can be shortened or ~~dismissed~~ waived. A concessionary release form should be completed.		Guidelines around oral PrEP have recently changed. Instead of a three-month deferral period, current guidance is to inform the TC of the PrEP and it is their discretion on whether a three month deferral period is required. If the TC feels that the risks of delaying the donation outweigh the risks of a false negative HIV result, then the deferral period can be shortened or waived. A concessionary release form should be completed at the time of clearance if the donation proceeds.

	For CT&LS donors whose cells will not be used for human application, donation may proceed if the client is informed and gives their approval. In such cases, a risk assessment should be completed.		For CT&LS donors whose cells will not be used for human application, donation may proceed if the client is informed and gives their approval. In such cases, a risk assessment should be completed.

Maram.Ghiti@anthonynolan.org: /* Individual at Risk */

2024-12-19T16:29:02Z

Individual at Risk

← Older revision		Revision as of 16:29, 19 December 2024
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	==Individual at Risk==		==Individual at Risk==
	Recipient		Recipient, Donor

	==Explanation of Condition==		==Explanation of Condition==
	Pre-Exposure Prophylaxis (PrEP) is used to prevent HIV infection. The main risk associated with PrEP is that it can give false negative HIV NAT results, meaning that early HIV infections may not be picked up. However, false positive HIV antibody results can also occur.		Pre-Exposure Prophylaxis (PrEP) is used to prevent HIV infection. The main risk associated with PrEP is that it can give false negative HIV NAT results, meaning that early HIV infections may not be picked up. However, false positive HIV antibody results can also occur.

Maram.Ghiti@anthonynolan.org: /* Explanation of Condition */

2024-12-19T16:28:51Z

Explanation of Condition

← Older revision		Revision as of 16:28, 19 December 2024
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	==Explanation of Condition==		==Explanation of Condition==
	Pre-Exposure Prophylaxis (PrEP) is used to prevent HIV infection.		Pre-Exposure Prophylaxis (PrEP) is used to prevent HIV infection. The main risk associated with PrEP is that it can give false negative HIV NAT results, meaning that early HIV infections may not be picked up. However, false positive HIV antibody results can also occur.
	The main risk associated with PrEP is that it can give false negative HIV results, meaning that early HIV infections may not be picked up.

Maram.Ghiti@anthonynolan.org: /* Justification for guidance */

2024-12-19T16:28:25Z

Justification for guidance

← Older revision		Revision as of 16:28, 19 December 2024
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	Pre-Exposure Prophylaxis (PrEP) is used to prevent HIV infection.		Pre-Exposure Prophylaxis (PrEP) is used to prevent HIV infection.
	The main risk associated with PrEP is that it can give false negative HIV results, meaning that early HIV infections may not be picked up.		The main risk associated with PrEP is that it can give false negative HIV results, meaning that early HIV infections may not be picked up.

	~~==Justification for guidance==~~
	~~PrEP may alter HIV testing, resulting in an unclear or negative result in HIV positive donors, with a potential risk of transmission of this virus to patients.~~

	We care a lot about the health of our donors. If you've been using medications like PrEP or PEP to prevent HIV, it could affect the accuracy of HIV tests for up to 3 months after you stop using them (Seed et al, 2020 - [https://espace.library.uq.edu.au/data/UQ_25f1211/UQ25f1211_OA.pdf?Expires=1700906000&Key-Pair-Id=APKAJKNBJ4MJBJNC6NLQ&Signature=RUtNkW7DAeNiYuVCx7khuVhmRY91jP7jWN7OuPW-G6zerKmiY24GmaaZjqR9b5E3aNimH~Hbx8rDtzJt43UFOUe7~C468BE13pofA72j8eox0QT1W7ceXk8itpALlSHUv~wYYXVw2YyzQcKX9G-8dbdLEwg41bGpE7YfG-0Sc0XHT38w64uG9mGdK4-JUt3Kby6MeIgykqqxH74n-~yVoIFmoe81pJtUKidEfZZdiXELpXsb80Aymx-HxZc2vPveVBybbpBy40Lxknt0o9w9t9QyjZgv~zLcz2hdmyx4IWAQBS6~UhtzFYZl~CB~c6-CWcYHHxWI8F42~-xRyvuYMg__]). Because of this, health authorities worldwide, including the UK, advise that if you've used PrEP or PEP in the last 3 months, you shouldn't donate.

Maram.Ghiti@anthonynolan.org: /* Acceptability at CT / Work-Up */

2024-12-19T16:27:44Z

Acceptability at CT / Work-Up

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 ==Acceptability at CT / Work-Up==
-Guidelines around PrEP have recently changed. Instead of a three month deferral period, current guidance is to inform the TC of the PrEP and it is their discretion on whether a three month deferral period is required. If the TC feels that the risks of delaying the donation outweigh the risks of a falsely negative HIV result, then the deferral period can be shortened or dismissed.
 ==Individual at Risk==

Maram.Ghiti@anthonynolan.org: /* Explanation of Condition */

2024-08-01T08:28:40Z

Explanation of Condition

← Older revision		Revision as of 08:28, 1 August 2024
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	==Explanation of Condition==		==Explanation of Condition==
	Pre-Exposure Prophylaxis (PrEP) is used to prevent HIV infection.		Pre-Exposure Prophylaxis (PrEP) is used to prevent HIV infection.
	The main risk associated with PrEP is that it can give false negative HIV results, meaning that early HIV infections ~~are~~ not picked up.		The main risk associated with PrEP is that it can give false negative HIV results, meaning that early HIV infections may not be picked up.

	==Justification for guidance==		==Justification for guidance==

Maram.Ghiti@anthonynolan.org: /* Explanation of Condition */

2024-08-01T08:28:10Z

Explanation of Condition

← Older revision		Revision as of 08:28, 1 August 2024
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	==Explanation of Condition==		==Explanation of Condition==
	Pre-Exposure Prophylaxis (PrEP) is used to prevent HIV infection		Pre-Exposure Prophylaxis (PrEP) is used to prevent HIV infection.
			The main risk associated with PrEP is that it can give false negative HIV results, meaning that early HIV infections are not picked up.

	==Justification for guidance==		==Justification for guidance==

Maram.Ghiti@anthonynolan.org: /* Acceptability at CT / Work-Up */

2024-08-01T08:27:10Z

Acceptability at CT / Work-Up

← Older revision		Revision as of 08:27, 1 August 2024
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	==Acceptability at CT / Work-Up==		==Acceptability at CT / Work-Up==
	~~Acceptable if~~ the ~~donor has not taken~~ PrEP ~~for at least 3 months + there~~ is ~~low sexual risk behaviour~~. ~~Please discuss with~~ the ~~MO team.~~		Guidelines around PrEP have recently changed. Instead of a three month deferral period, current guidance is to inform the TC of the PrEP and it is their discretion on whether a three month deferral period is required. If the TC feels that the risks of delaying the donation outweigh the risks of a falsely negative HIV result, then the deferral period can be shortened or dismissed.

	~~Otherwise postpone~~.

	==Individual at Risk==		==Individual at Risk==

Frances.Sarkari@anthonynolan.org: /* Acceptability at CT / Work-Up */

2023-11-30T13:05:07Z

Acceptability at CT / Work-Up

← Older revision		Revision as of 13:05, 30 November 2023
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	==Acceptability at CT / Work-Up==		==Acceptability at CT / Work-Up==
	Acceptable if the donor has ~~been off~~ PrEP for at least 3 months + there is low sexual risk behaviour.		Acceptable if the donor has not taken PrEP for at least 3 months + there is low sexual risk behaviour. Please discuss with the MO team.

	Otherwise postpone.		Otherwise postpone.

← Older revision		Revision as of 16:36, 19 December 2024
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	PrEP – Pre-Exposure Prophylaxis		PrEP – Pre-Exposure Prophylaxis
			PEP - Post-Exposure Prophylacis


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	==Acceptability at CT / Work-Up==		==Acceptability at CT / Work-Up==

	Donors should be asked whether they currently take oral PrEP or have taken it in the past three months, or if they have received injectable PrEP within the last 24 months.		Donors should be asked whether they currently take oral PrEP/PEP or have taken it in the past three months, or if they have received injectable PrEP within the last 24 months.

	Transplants centres should be informed as soon as possible at the VT stage if the above apply.		Transplants centres should be informed as soon as possible at the VT stage if the above apply.

	Donors should not be asked to stop PrEP to donate. The health and well-being of the donor is our top priority, and PrEP significantly ~~reduces~~ the risk of HIV transmission.		Donors should not be asked to stop PrEP/pep to donate. The health and well-being of the donor is our top priority, and PrEP/PEP significantly reduce the risk of HIV transmission.

	Guidelines around oral PrEP have recently changed. Instead of a three-month deferral period, current guidance is to inform the TC of the PrEP and it is their discretion on whether a three month deferral period is required. If the TC feels that the risks of delaying the donation outweigh the risks of a false negative HIV result, then the deferral period can be shortened or waived. A concessionary release form should be completed at the time of clearance if the donation proceeds.		Guidelines around oral PrEP/PEP have recently changed. Instead of a three-month deferral period, current guidance is to inform the TC of the PrEP and it is their discretion on whether a three month deferral period is required. If the TC feels that the risks of delaying the donation outweigh the risks of a false negative HIV result, then the deferral period can be shortened or waived. A concessionary release form should be completed at the time of clearance if the donation proceeds.

	For CT&LS donors whose cells will not be used for human application, donation may proceed if the client is informed and gives their approval. In such cases, a risk assessment should be completed.		For CT&LS donors whose cells will not be used for human application, donation may proceed if the client is informed and gives their approval. In such cases, a risk assessment should be completed.

	It is noteworthy that PrEP can affect HIV test results. It carries a risk of false-negative NAT results and may also cause false-positive HIV antibody results.		It is noteworthy that PrEP/PEP can affect HIV test results. It carries a risk of false-negative NAT results and may also cause false-positive HIV antibody results.

	If a positive HIV antibody result is detected in a donor who is taking or has recently taken PrEP, the work-up should be cancelled, and the donor referred back to their healthcare team. A follow-up blood test would typically be performed three months after discontinuing PrEP to ensure accurate results. The donor can remain on the register until testing is completed, though if a true positive HIV resultis identified, they should be removed from the register.		If a positive HIV antibody result is detected in a donor who is taking or has recently taken PrEP/PEP, the work-up should be cancelled, and the donor referred back to their healthcare team. A follow-up blood test would typically be performed three months after discontinuing PrEP/PEP to ensure accurate results. The donor can remain on the register until testing is completed, though if a true positive HIV resultis identified, they should be removed from the register.

	Discontinuing PrEP carries potential risks and can cause anxiety during the waiting period. Donors should be fully informed of these risks when PrEP use is identified, allowing them to make an informed decision about whether to proceed with the work-up process, which includes HIV testing.		Discontinuing PrEP/PEP carries potential risks and can cause anxiety during the waiting period. Donors should be fully informed of these risks when PrEP/PEP use is identified, allowing them to make an informed decision about whether to proceed with the work-up process, which includes HIV testing.

	Injectable PrEP may interfere with HIV test results for up to 24 months following the last dose, and so the above considerations apply for 24 months.		Injectable PrEP may interfere with HIV test results for up to 24 months following the last dose, and so the above considerations apply for 24 months.
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	==Explanation of Condition==		==Explanation of Condition==
	Pre-Exposure Prophylaxis (PrEP) is used to prevent HIV infection. The main risk associated with PrEP is that it can give false negative HIV NAT results, meaning that early HIV infections may not be picked up. However, false positive HIV antibody results can also occur.		Pre-Exposure Prophylaxis (PrEP) is used to prevent HIV infection. The main risk associated with PrEP is that it can give false negative HIV NAT results, meaning that early HIV infections may not be picked up. However, false positive HIV antibody results can also occur.

			Post-Exposure Prophylaxis (PEP) has a similar mechanism of action to PrEP and may also interfere with testing results. In the UK PEP is prescribed to people who have been exposed to someone who may have HIV. This includes through sexual activity or exposure through a needle stick injury.