[Use of non-occupational HIV post-exposure prophylaxis in Spain (2001-2005)]

Non-occupational post-exposure prophylaxis for human immunodeficiency virus (HIV) infection is widely used, although there is little available scientific evidence to support its effectiveness. The aim of this study is to describe the characteristics of the persons exposed, types of exposures, antiretroviral treatment prescribed, and outcome of HIV infection in cases of non-occupational exposure in Spain.

The data used included all cases of accidental HIV exposure notified to the Non-occupational Post-exposure Prophylaxis Information System between January 2001 and December 2005. Non-occupational exposure to HIV was defined as accidental contact with blood and/or other biological fluids outside the healthcare setting.

A total of 993 cases of exposure were notified (569 men [57.3%]); median age was 30 years (range: 1-87). Exposure was sexual in 53.1%, parenteral in 39.8%, and other types in 7.2%. The source person was identified in 82.7% of cases. Antiretroviral treatment (ART) was prescribed in 528 cases (53.2%), with triple therapy in 68.2%. A total of 54.2% returned for the 6-month visit among patients receiving ART and 61.1% among those without this therapy (P < 0.05). One or more side effects developed in 135 (32.4%) cases, and there were 18 treatment interruptions (4.3%). Three seroconversions to HIV were notified (0.3%).

A national registry for monitoring non-occupational post-exposure prophylaxis to HIV is needed because of the high number of cases notified, the considerable incidence of side effects, and the difficulties of follow-up.