Carli GD, Puro V, Cicalini S, Mattioli F, Lazarevic Z, Ippolito G; International Conference on AIDS; IRAPEP.
Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. WePeC6142.
INMI Spallanzani, Rome, Italy
BACKGROUND: HIV post-exposure prophylaxis (PEP) is recommended for occupational exposure and considered after nonoccupational exposure to HIV. METHODS: To monitor PEP, a National Registry was instituted by the Italian Ministry of Health. RESULTS: From Jan 1997 to Dec 2001, 903 (67%) occupational exposures in healthcare workers (HCW), and 264 (23%) non HCW exposures were collected; drop-outs were 2% and 4.5%, respectively. No seroconversions were reported. HCW exposures were 548 needlesticks, 87 cuts, 240 mucocutaneous contaminations, and 43 others/unavailable. HCW acceptance increased from 35% in 1997 to 52% in 2001. Initial regimens included 2 NRTI (gr.A) in 394 cases, (366 ZDV+3TC), plus 1 protease inhibitor (PI) (gr.B) in 482 cases (ZDV+3TC+IDVin 432). Nevirapine was rarely used. 223 HCW interrupted PEP when the source tested negative, after a mean of 3d, median 2, range 1-13; of these, 8% developed side effects. For non-HCW (102 cases in gr.A and 147 in gr.B), 66 were occupational exposures occurring outside the healthcare setting and 198 other exposures (of which, 4 needlesharings, and 80 sexual exposures). Mean time of starting PEP was 4.40h, 16h and 5.5h among HCW, sexual and other exposures. Mean PEP duration was 16d for HCW (median 8, range 1-60) and 24d for non HCW (29, 1-46); 37% HCW and 61% non HCW completed the 4-week regimen. Overall, 27% of gr.A and 41% of gr.B reported at least one mild and reversible side effect, mostly gastrointestinal (60%). 14% HCW and 11% non HCW interrupted PEP because of side effects. Renal colic occurred in 7 cases, decreased Hb (11), and increased bilirubin (23) and AST levels (14), were all observed in gr.B. CONCLUSION: We observed an increasing use of occupational and of not formally approved non occupational PEP, and of PI containing regimens as an initial regimen. Efforts should be made to ensure a rapid assessment of the source's serostatus in order to limit unnecessary PEP and its related toxicity and costs.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Anti-HIV Agents
- Drug Therapy, Combination
- HIV
- HIV Infections
- HIV Protease Inhibitors
- HIV Seronegativity
- Health Personnel
- Lamivudine
- Needlestick Injuries
- Nevirapine
- Occupational Exposure
- Registries
- Zidovudine
- drug therapy
- immunology
- therapy
Other ID:
UI: 102252220
From Meeting Abstracts