Antiretroviral prophylaxis for community exposure to the human immunodeficiency virus in Switzerland, 1997-2000.

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State: Public
Version: author
Serval ID
serval:BIB_2BBD0D5C311D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Antiretroviral prophylaxis for community exposure to the human immunodeficiency virus in Switzerland, 1997-2000.
Journal
Swiss medical weekly
Author(s)
Bernasconi E., Jost J., Ledergerber B., Hirschel B., Francioli P., Sudre P.
ISSN
1424-7860 (Print)
ISSN-L
0036-7672
Publication state
Published
Issued date
28/07/2001
Peer-reviewed
Oui
Volume
131
Number
29-30
Pages
433-437
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To analyse the data from Swiss nationwide voluntary reporting on non-occupational HIV-postexposure prophylaxis (HIV-PEP) by prescribing physicians.
One hundred and seventy-six persons, who received antiretroviral prophylaxis for community exposure to HIV between December 1997 and March 2000, were included in this prospective cohort study with standardised data collection. Information on the source, the exposed person, type of exposure, treatment, and outcome was reported by physicians on a voluntary basis to three co-ordinating centers.
HIV-PEP was prescribed predominantly following sexual exposure (69%). Needle injury was the second most common type of exposure (19% of all exposures), mostly occurring in a non-healthcare related "professional" setting (i.e., housekeepers, concierges [caretakers], and policemen). Needle sharing accounted for only 4% of all cases of exposure. The HIV status of the source often remained unknown (56%). Most patients received a combination of three antiretroviral drugs (zidovudine/lamivudine/nelfinavir in 34.1%; zidovudine/lamivudine/indinavir in 22.8%; zidovudine/lamivudine/nevirapine in 18.6%; various triple combinations in 13.8%). Follow-up information was available for 86 patients. In this group 78 (91%) completed at least one week of prophylaxis. Side-effects were common (70.9%), particularly diarrhoea (29.6%) and nausea (20.9%). Two patients experienced severe side effects, nephrolithiasis with sepsis, and toxic hepatitis, respectively.
In most of the cases where HIV-PEP was prescribed the indication was questionable, with the HIV status of the source unknown. The role of HIV-PEP as part of HIV prevention programs should be well defined in view of the cost and potential for causing severe side-effects.

Keywords
Adolescent, Adult, Aged, Anti-HIV Agents/administration & dosage, Anti-HIV Agents/adverse effects, Anti-HIV Agents/therapeutic use, Blood-Borne Pathogens, Child, Drug Administration Schedule, Drug Combinations, Female, HIV Infections/drug therapy, HIV Seropositivity/drug therapy, Humans, Male, Middle Aged, Switzerland
Pubmed
Web of science
Create date
25/01/2008 17:08
Last modification date
20/08/2019 13:11
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