In step 2 of our guide, let’s check now your health background and make sure that PrEP is safe for you.
A-Is PrEP Safe For Me?- Kidney Assessment
In order to help you asses your kidney functions, Please order a blood test that includes kidney tests (Creatinine, Urea, Uric acid).
Please calculate according to your test results your estimated glomerular filtration rate eGFR:
You can use an eGFR calculator.
When Is PrEP Safe For Your Kidneys?
1-In case your EGFR is lower than 60 mL/min/1.73 m2 – Please consult a nephrologist.
If you don’t have access to a nephrologist consult our medical doctor on our chat service. Press the green chat icon at the bottom f the screen.
2- In case your EGFR is higher than 60 mL/min/1.73 m2
Do you have any of the following (if the answer is no, you passed successfully this step and you can move to step B)?
- Do you have diabetes?
Please consult a nephrologist. If you don’t have access to a nephrologist consult our medical doctor on our chat service Press the green chat icon at the bottom of the screen.
- Do you have high blood pressure?
Please consult a nephrologist.
If you don’t have access to a nephrologist consult our medical doctor on our chat service Press the green chat icon at the bottom of the screen.
- Are you older than 40?
Please consult a nephrologist. If you don’t have access to a nephrologist consult our medical doctor on our chat service. Press the green chat icon at the bottom of the screen.
- Do you take any chronic medications, therapies or supplements?
Please consult a nephrologist. If you don’t have access to a nephrologist consult our medical doctor on our chat service. Press the green chat icon at the bottom of the screen.
B- Is PrEP Safe For Me?- What Is Your HIV Status:
1- I am HIV positive- Cannot use Prep as it can cause drug resistance.
2- I am HIV negative.
Please perform a fourth-generation antigen/antibody assay blood test before initiating the therapy. To ensure you are still negative.
3- I don’t know what is my HIV status.
Please perform a fourth-generation antigen/antibody assay blood test before initiating the therapy. To ensure you are negative.
If you performed fourth-generation antigen/antibody assay blood test Please check you are not in the following groups as they need more assessment.
Please check if you are in the following groups.
An additional HIV RNA test is required to asses for recent HIV infection that might not be detected on fourth-generation antigen/antibody assay:
1- Lately you Experienced symptoms of viral disease that are similar to acute HIV infection (eg, lymphadenopathy, fever, malaise, and/or a maculopapular eruption).
2- Your result from the antigen/antibody wasn’t clear and was intermediate.
3- If you had lately a high-risk exposure (eg, recent sexual exposure to a partner with documented untreated HIV infection) within four weeks of starting PrEP, regardless of symptoms.
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If at the end of this step you are negative in all recommended tests for you, please check step C.
C- Is PrEP Safe For Me?- What Is Your Hepatitis B Status?
Please order blood tests for Hepatitis B antibodies/antigens:
Please perform the following tests:
anti-HBs-, anti-HBc-, HBsAg
1-In case the 3 are negative you need to get vaccinated before starting PrEP therapy.
2-anti-HBs- and anti-HBc-positive- or anti–HBs positive and anti-HBc negative (do not require any further assessment), Proceed to Step D.
3-HBsAG positive- please consult your own doctor preferably infectious disease expert as you have a chronic hepatitis B infection. (In case you don’t have access to a medical consultant please contact our medical doctor on our chat service).
4-anti-HBc-positive alone (with negative HBsAg, anti-HBs ): please consult your doctor as you might be in the stage of resolving the disease and better is to refrain from PrEP at this stage as it might cause a flare in your disease.
D-Is PrEP Safe For Me?-What Is Your Hepatitis C Status?
Please perform a test for Anti-HCV.
In case it is positive (Positive Anti-HCV), Don’t take PrEP! Please consult your therapist. If you don’t have access to a nephrologist consult our medical doctor on our chat service Press the green chat icon at the bottom of the screen.
E-Is PrEP Safe For Me?-What Is Your Hepatitis A Status?
Please perform a test for Anti-HAV IgM and IgG.
In case your IgG is positive and IgM is negative you can proceed as you are protected from Hepatitis A. Proceed to F.
In case your IgM and IgG are negative, you need to get vaccinated before taking PrEP.
In case your IgM is positive or intermediate. You had a recent HAV infection. Don’t take PrEP! Please consult your therapist. If you don’t have access to a nephrologist consult our medical doctor on our chat service Press the green chat icon at the bottom of the screen.
F-Is PrEP Safe For Me?-Osteoporosis:
Only for people with chronic disease, females older than 50, bone diseases, absorption diseases, cancer, inflammatory disease, obesity, metabolic diseases, under chronic medical therapy that might cause malabsorption. If you are not in these groups- Proceed to G.
In case you believe you might have a decreased bone density for any of the reasons mentioned above, please consult your medical doctor. If you don’t have access to a nephrologist consult our medical doctor on our chat service Press the green chat icon at the bottom of the screen.
Patients with osteoporosis or osteopenia must consult their medical doctor to understand the risk factors of prep in this case.
We recommend you to use the following calculator.
G-Is PrEP Safe For Me?-Pregnancy:
All women in childbearing age should perform a pregnancy test, Blood beta HCG.
In case positive they should consult a local medical practitioner. (In case you don’t have access to a medical consultant please contact our medical doctor on our chat service).
If you managed to pass all steps, you are ready now for step 3, how to take PrEP.