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Expanded postexposure prophylaxis for simultaneous multiple source HIV exposure in a health-care worker.
I G Baraboutis1, V Papastamopoulos, O Georgiou
1Division of Infectious Disease and HIV, 5th Department of Internal Medicine, Evaggelismos General Hospital, Ipsilantou 45-47, 10676 Athens. ioannisbaraboutis@yahoo.gr
International Journal of STD & AIDS
|January 22, 2010
Summary
A healthcare worker experienced a severe needlestick exposure to HIV-infected blood. Post-exposure prophylaxis with raltegravir was successfully used to prevent HIV transmission.
Area of Science:
- Infectious Diseases
- Occupational Health
- Virology
Background:
- Healthcare workers face risks of occupational exposure to bloodborne pathogens.
- Automated analyzers can pose unique exposure risks during operation.
Observation:
- A healthcare worker had a high-grade needlestick exposure to serum from multiple Human Immunodeficiency Virus (HIV)-infected patients.
- The exposure occurred while attempting to prematurely remove tubes from an automated biochemical analyzer.
Findings:
- An expanded post-exposure prophylaxis (PEP) regimen was recommended, including an entry inhibitor (enfuvirtide) and an integrase inhibitor (raltegravir).
- The healthcare worker opted for oral raltegravir, completing the therapy without complications.
- Follow-up evaluations for HIV transmission up to nine months post-incident were negative.
Implications:
- This case highlights the importance of adhering to safety protocols with automated laboratory equipment.
- Alternative PEP regimens, such as oral integrase inhibitors, can be effective when injectable options are refused.
- Prompt and appropriate PEP is crucial in preventing occupational HIV transmission in healthcare settings.
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