Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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Although some individuals who present for antiretroviral postexposure prophylaxis (PEP) had a 1-time exposure to human immunodeficiency virus (HIV), others may be recurrently risky. Given that preexposure prophylaxis (PrEP) has been shown to be efficacious, identification of those individuals who present for PEP who might benefit from PrEP is important to decrease HIV acquisition in high-risk individuals. While inclusion criteria for PrEP have been developed, there is a paucity of data to help clinicians determine which PEP users are at highest risk for HIV acquisition and therefore should be offered PrEP. We will discuss the rationale for using PrEP after PEP use, and will focus on the assessment of PEP users who may benefit from PrEP.
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Although much recent focus has been on the recognition of Ebola virus disease among travelers from West Africa, cases of Middle East respiratory syndrome coronavirus (MERS-CoV), including travel-associated cases, continue to be reported. US clinicians need to be familiar with recommendations regarding when to suspect MERS-CoV, how to make a diagnosis, and what infection control measures need to be instituted when a case is suspected. ⋯ Two cases of MERS-CoV were identified in the United States in May 2014; because these cases were detected promptly and appropriate control measures were put in place quickly, no secondary cases occurred. This paper summarizes information that US clinicians need to know to prevent secondary cases of MERS-CoV from occurring in the United States.