What is the most appropriate post-exposure prophylaxis for a doctor after a needlestick injury from a patient with HIV?

The most appropriate post-exposure prophylaxis (PEP) for a healthcare worker who has sustained a needlestick injury from a patient known to be HIV-positive is three-drug antiretroviral treatment for 1 month. This strategy is recommended to effectively reduce the risk of HIV transmission after potential exposure.

In the context of PEP, guidelines indicate that initiating treatment as soon as possible after exposure maximizes efficacy, ideally within 72 hours. The use of a three-drug regimen is considered the standard to ensure more reliable viral suppression and to provide a stronger defense against potential infection, especially if the source patient has a high viral load.

While single-drug regimens are easier to manage and are sometimes prescribed for certain low-risk exposures, they do not offer adequate protection in the context of a needlestick injury where the findings and patient history might indicate a higher likelihood of HIV transmission. Two-drug regimens are also less effective than three-drug combinations and are not typically used in this scenario.

Therefore, the use of a three-drug antiretroviral regimen is robustly supported by clinical guidelines and research, emphasizing its role in effectively preventing HIV infection after exposure.