Infection control: HIV post-exposure prophylaxis: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Microbiology · Infection control: HIV post-exposure prophylaxis

Sample item

A staff nurse sustains a deep needlestick injury with a hollow-bore needle from a patient known to be HIV positive. She presents one hour later. Which approach is most appropriate under the Indian national guidelines?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Start a three-drug regimen of tenofovir, lamivudine and dolutegravir as soon as possible for 28 days

After a significant percutaneous exposure to HIV, post-exposure prophylaxis should begin as early as possible, ideally within 2 hours and no later than 72 hours, and continue for 28 days. The national programme recommends a three-drug regimen of tenofovir, lamivudine and dolutegravir after wound washing and baseline testing. Follow-up testing is done for months afterwards.

Option by option

  • A. Give HIV immunoglobulin and hepatitis B vaccine

    There is no HIV immunoglobulin, and hepatitis B vaccine does not protect against HIV.

  • B. Wait for her three-month HIV test before any treatment

    Delaying treatment until a three-month test misses the window in which prophylaxis works.

  • C. Give zidovudine alone for six weeks

    A single agent is inadequate for a high-risk exposure and is no longer recommended.

  • D. Start a three-drug regimen of tenofovir, lamivudine and dolutegravir as soon as possible for 28 days (correct)

    Early three-drug antiretroviral therapy for 28 days is the recommended prophylaxis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is D, Start a three-drug regimen of tenofovir, lamivudine and dolutegravir as soon as possible for 28 days. After a significant percutaneous exposure to HIV, post-exposure prophylaxis should begin as early as possible, ideally within 2 hours and no later than 72 hours, and continue for 28 days.

Why is "Give HIV immunoglobulin and hepatitis B vaccine" not the answer?

There is no HIV immunoglobulin, and hepatitis B vaccine does not protect against HIV.

Why is "Wait for her three-month HIV test before any treatment" not the answer?

Delaying treatment until a three-month test misses the window in which prophylaxis works.

Why is "Give zidovudine alone for six weeks" not the answer?

A single agent is inadequate for a high-risk exposure and is no longer recommended.

What concept does this question test?

It tests Infection control: HIV post-exposure prophylaxis in Microbiology. The national programme recommends a three-drug regimen of tenofovir, lamivudine and dolutegravir after wound washing and baseline testing. Follow-up testing is done for months afterwards.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infection control: HIV post-exposure prophylaxis?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.