Benais J, Miara A, Brion S, Delaitre D, Werson P, Soussy A, Garnier M; International Conference on AIDS.
Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. TuOrC314.
Jean-PierreBenais, Hospital Jean-Verdier Av du 14 Juillet, Service des Urgences Medico-judiciaires, 931 43 Bondy, France, Tel.: +33 1 4802 6559, Fax: +33 1 4802 6557, E-mail: jean-pierre.benais@jvr.ap-hop-pairs.fr
Background: A procedure for treating sexual assault in the Paris region has been in operation since June 1999. It is based on a collaboration between referring doctors from different emergency medico-legal centre (5) including 6 million residents. Operating 24 h/24 h these units have received 750,000 victims in 1999 and examined 2550 rapes cases. Methods: Antiretrovital treatment is begun if the assult took place within the previous 48 hours and consists of a combination of two nucleoside inhibitor (D4T and DDI) and a protease inhibitor (nelfinavir). The treatment schedule is as follows: DO biochimical, haematological, serological tests, pregnancy test and initial prescription for 48 h. D2 the patient is reviewed in the light of firt results and a prescrition is issued for 28 days, D15, D30, D60: idem procedure. The treatment is stopped at D30. We have choosen this prophylactic treatment because we assumed that a perpetrator who might be potentially seroposive had, thefore, a greater chance of being treated with a combination that included AZT. The mutation most commonly encountered are those associated with a reduction in sensitivity to AZT. For is reason it was rected. The drugs D4T and DDI were chosen because of the reported low incidence of genotypic resistance. Results: A total of 100 patients were treated according to the above protocol. Two perpatrators were known as seropositive and the others refused testing. None of the patient in our study exhibited seroconversion. The initial results of the study show that these was no significant change in the biochimical parameters due to the treatment. The only problems encountered were clinical and personal discomfort. In somme cases these effects led to the stoppage of treatment. Conclusion: Previously on instituting a preventive antiretroviral treatment in a cohort of 5000 victims of sexual assault in the Paris region, it was confirmed that almost no seroconversion took place after rape. Similarly, none of the patients in this study exhibited seroconversion although it should be noted that 25% of patients never returned for their appointement (psychological reasons and very specific population). Nevertheless, the risk is not zero (0.32%) and the express request of victims to be put on treatment quickly, the execellent tolerability of our therapeutic choice drugs, the apparent absence of biochimical changesdue to this short treatment and, above all, the obligation under French law to institute antiretroviral treatment all have encouraged us to continue using this approach.
Publication Types:
Keywords:
- Biomedical Research
- Crime
- Crime Victims
- Female
- Health Personnel
- Humans
- Incidence
- Legislation
- Paris
- Pregnancy
- Rape
- Sex Offenses
- therapy
Other ID:
UI: 102239223
From Meeting Abstracts