Department of Infectious Diseases & Immunology
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PEP Regime for Children Under 9 Years PIAG M11 (322kB)
Introduction
A specially trained doctor / nurse has assessed your child following an event. During this event, your child may have been exposed to Human Immunodeficiency Virus (HIV), or other viruses carried in the blood such as hepatitis B or C. If this was a sexual exposure, your child may also be at risk of other sexually transmitted infections or an unwanted pregnancy.
In some cases, a short course of drug treatment may be advised. This treatment is known as post exposure prophylaxis or “PEP”.
What is PEP?
The doctor / nurse has assessed that your child has a risk of catching HIV from their recent exposure. This risk can be greatly reduced by taking a course of “Post Exposure Prophylaxis”, or “PEP”, for 28 days. Starting PEP as early as possible, taking every dose as prescribed and completing the 28-day course provides the best protection against infection. Therefore, your child should:
- Be given the first dose of medication immediately.
- Attend the follow up appointment as advised by the person who prescribed the PEP.
What are the medications involved?
The treatment consists of a combination of antiviral drugs which are effective against the HIV virus. Used together, there is evidence1 that they can reduce the risk of developing HIV infection following exposure. The names of your child’s medicines are:
- Ritonavir / Lopinavir (Kaletra®) tablets
- Lamivudine with Zidovudine tablets
When should I give the medications?
You should give the first dose of your child’s medications as soon as you receive them.
These medications should be taken just after a meal. If you have taken your first dose at an unusual time, you can adjust the doses gradually (1-2 hours each time) until they are at a standard time (e.g. 9am).
If your child cannot swallow tablets, they will be prescribed:
- Zidovudine syrup, Lamivudine syrup and Ritonavir / Lopinavir (Kaletra®) syrup.
- Ritonavir / Lopinavir syrup has a poor taste, so tablets should be used where possible.
These medications should be taken just after a meal.
If you have taken your first dose at an unusual time, you can adjust the doses gradually (1-2 hours each time) until they are at a standard time (e.g. 9am).
Missing Doses
You should not miss giving your child any doses. Missing doses may increase the chance that the treatment doesn’t work. If you forget to give a dose, give it as soon as possible and then continue as before. If you have difficulty remembering to take them, use an alarm, e.g. on your mobile phone.
Are there any side effects?
The PEP medicines can cause side effects such as sickness, headache, and tiredness. If your child experiences side effects and feel they can no longer take the medicines, please seek medical advice as soon as possible, as alternatives may be available.
If your child develops a rash or flu-like illness (e.g. sore throat, fever, muscle pains, enlarged glands) whilst taking this medicine, or during the 12 weeks after finishing treatment, contact your child’s clinic immediately to discuss your child’s symptoms. This is to ensure they are not an allergic reaction or signs of HIV infection.
My child is taking other medications, can I still give them PEP?
The PEP medicines may interact with other medicines, including those you have bought yourself and herbal remedies. If your child normally takes any medications, prescribed or non-prescribed, let medical staff know. Do not start your child on any new medication without discussing with their doctor first.
Important Advice
- Do keep your medicines in a cool, dark, dry place, out of the reach of children.
- Do not take more than the recommended dose of your PEP
- Do not give your medicines to others
Follow Up
At the follow up clinic appointment the potential side effects of these medications will be discussed in more detail. Appropriate monitoring, follow up and support will also be arranged by the doctor or nurse. The starter pack of medications may not contain a complete 28 day supply, but the remainder will be arranged at the follow-up appointment.
Contact numbers
If you have any concerns regarding any aspect of PEP, please contact: Monday to Friday 9am to 5pm: Infectious Diseases and Immunology Nurse on 07766443940
Outside of these hours, call Alder Hey hospital on 0151 252 4811 and ask for the on-call Infectious Diseases/Microbiology Consultant.
References
- Post-exposure prophylaxis guidelines for children and adolescents potentially exposed to HIV. Bamford A, Tudor-Williams G, Foster C. Arch Dis Child. 2017 Jan;102(1):78-83
This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.
This information can be made available in other languages and formats if requested.
PIAG: M11