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Post-exposure prophylaxis.

Marchina E van der Ende1, Rosa M Regez, Gerrit Schreij

  • 1Department of Internal Medicine, Eramus MC, Rotterdam, The Netherlands. vanderende@inw2.azr.nl

International Journal of STD & AIDS
|January 23, 2003
PubMed
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Post-exposure prophylaxis (PEP) is recommended to prevent HIV transmission after occupational, drug use, or sexual exposure. In the Netherlands, PEP is feasible and safe, with no occupational HIV seroconversions recorded.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Occupational, injecting drug use, and sexual exposures carry a risk of HIV transmission, ranging from <0.1% to 3%.
  • Higher plasma HIV-RNA in the source, larger inoculum volume, co-existing sexually transmitted diseases, and mucous membrane breaches increase transmission risk.
  • Risk assessment is crucial for determining the need for post-exposure prophylaxis (PEP).

Purpose of the Study:

  • To evaluate the feasibility and safety of prescribing PEP in occupational settings.
  • To assess the incidence of adverse events associated with antiretroviral PEP.
  • To report on HIV seroconversions in occupational accident cases in the Netherlands.

Main Methods:

  • Retrospective analysis of occupational exposure cases.

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  • Review of PEP prescription data and adverse event reporting.
  • Monitoring of HIV seroconversion rates following occupational accidents.

    • Main Results:

    • PEP prescription in occupational settings is a standard and feasible procedure in the Netherlands.
    • Mild and reversible toxicity was reported in 62% of cases.
    • Serious adverse events occurred in 2% of cases, including nephrolithiasis and toxic hepatitis.
    • No HIV seroconversions were recorded after occupational accidents in the Netherlands.

    Conclusions:

    • PEP is an effective strategy to prevent HIV infection following occupational exposures.
    • Antiretroviral PEP is generally well-tolerated, with a low incidence of serious adverse events.
    • The implementation of PEP in occupational settings has successfully prevented HIV transmission in the Netherlands.