Cuando vea este tema en otro idioma, podría notar algunas diferencias en la estructura del contenido, pero aún refleja las últimas orientaciones basadas en la evidencia.

Profilaxis postexposición al VIH

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  • Diagnosis
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Evidence last reviewed: 3 Jul 2026
Topic last updated: 06 May 2026

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
  • exposición al VIH en las 72 horas anteriores
  • rotura, desplazamiento o ausencia de uso de condón
  • antecedentes de eyaculación del sujeto fuente
  • traumatismo o lesión en la piel
  • úlceras genitales
  • sujeto fuente proveniente del grupo de alto riesgo para la viremia del VIH
  • sujeto fuente proveniente de un área geográfica con una alta prevalencia de VIH
  • antecedentes sexuales de alto riesgo en la persona expuesta
  • carga viral de VIH detectable en el sujeto fuente
Full details

Other diagnostic factors

  • antecedentes de prueba negativa de VIH en el sujeto fuente
  • sujeto fuente con infección simultánea por hepatitis
  • resistencia antiviral al VIH en el sujeto fuente
  • fármacos que se adquieran actualmente, tanto con receta médica como sin ella
  • antecedentes de alergias a fármacos
  • enfermedades seudogripales
Full details

Risk factors

  • transfusión de sangre de un donante que vive con el VIH
  • rol pasivo en coito anal
  • el consumo de drogas inyectables y el uso compartido de agujas
  • lesión percutánea (por pinchazo con aguja)
  • rol activo en coito anal
  • relaciones sexuales vaginales receptivas
  • coito vaginal con penetración
  • sexo oral activo o pasivo
Full details

Diagnostic tests

1st tests to order

  • ensayo de inmunoabsorción enzimática (ELISA) de cuarta generación para la detección de antígenos y anticuerpos del VIH
  • Prueba de ácido nucleico del VIH
  • pruebas de función renal
  • pruebas de función hepática
  • serología de hepatitis B
  • serología de hepatitis C
  • prueba de embarazo
  • detección de otras infecciones de transmisión sexual (ITS)
Full details

Investigations to consider

  • Carga viral del VIH (en caso de síntomas de seroconversión del VIH)
Full details

Treatment algorithm

ACUTE

adultos o adolescentes ≥12 años: que no estén embarazadas

embarazada o en periodo de lactancia materna

niños

Contributors

Authors

Julie Fox, BSc(Hons), MBChB, MRCP, MD

HIV consultant and Honorary Senior Lecturer KCL

Department of HIV

Harrison Wing

Guy’s and St Thomas Hospital NHS Foundation Trust

London

UK

Disclosures

JF declares that she has no competing interests.

Acknowledgements

Dr Julie Fox would like to gratefully acknowledge Dr Ming Jie Lee, Dr Jennifer A. Johnson, Dr Paul Sax, Dr Rebecca Plank, Dr Michael Brady, Dr Emily Cheserem, and Dr Claire M. Naftalin, the previous contributors to this topic.

Disclosures

MJL has received consulting fees from Thriva Ltd. and conference reimbursement from Gilead Sciences, Inc., and travel grants from ViiV Healthcare, not related to this work. JAJ declares that she has no competing interests. PS serves as a consultant for Abbott, BMS, Gilead, GSK, Merck, and Janssen. He receives grant support from BMS, Gilead, and GSK. EC has been sponsored by GlaxoSmithKline for several conferences and sponsored by Gilead Sciences, Bristol-Myers Squibb Pharmaceuticals, and Abbott Laboratories to attend various educational programs. CMN has been sponsored by Bristol-Myers Squibb Pharmaceuticals to attend an educational program. CMN is an author of a reference cited in this topic. MB not disclosed. RP declares that she has no competing interests.

Peer reviewers

Professor Margaret Johnson, MB BS, MD, FRCP

Clinical Director

HIV/AIDS Services

Royal Free Hampstead NHS Trust

London

UK

Disclosures

MJ declares that she has no competing interests.

William Rodriguez, MD

Chief Medical Officer

Foundation for Innovative New Diagnostics (FIND)

Campus Biotech

Geneva

Switzerland

Disclosures

Not disclosed.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

World Health Organization​. Guidelines for HIV post-exposure prophylaxis. Jul 2024 [internet publication].Full text

British Association for Sexual Health and HIV. Post-exposure prophylaxis. Sep 2021 [internet publication].Full text

Tanner MR, O'Shea JG, Byrd KM, et al. Antiretroviral postexposure prophylaxis after sexual, injection drug use, or other nonoccupational exposure to HIV - CDC recommendations, United States, 2025. May 2025 [internet publication].Full text  Abstract

Kofman AD, Struble KA, Heneine W, et al. 2025 US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for post-exposure prophylaxis in healthcare settings. Infect Control Hosp Epidemiol. 2025 Sep;46(9):863-73.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • Guidelines

    • Antiretroviral postexposure prophylaxis after sexual, injection drug use, or other nonoccupational exposure to HIV - CDC recommendations, United States, 2025
    • Guidelines for HIV post-exposure prophylaxis
    More Guidelines

  • Patient information

    VIH: tratamiento de prevención (PrEP)

    Hepatitis C: ¿qué es?

    More Patient information
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