Use of HIV Postexposure Prophylaxis in Healthcare Workers after Occupational Exposure: A Thai University Hospital Setting(cid:31)
Sasisopin Kiertiburanakul MD*, Bunchong Wannaying BSc**, Sirirat Tonsuttakul BSc**, Pranee Kehachindawat MSW**, Siriluk Apivanich MSc**, Somporn Somsakul BSc **, Kumthorn Malathum MD*
Affiliation : (cid:31) The abstract was presented at the 2nd International Congress of the Asia Pacific Society of Infection Control, February 14-17, 2004, Singapore * Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University **Department of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Background : PostExposure Prophylaxis (PEP) is widely used after exposures to Human Immunodeficiency
Virus (HIV) to reduce the risk of infection in the healthcare setting. Few data are available on the safety and
tolerability of Anti Retro Viral drugs (ARV) among Health Care Workers (HCWs) who are prescribed prophylaxis.
Objective : To collect information about the safety and compliance of taking ARV for HIV PEP among HCWs.
Materials and Methods : Retrospective review on registry data regarding occupational HIV exposures, the PEP
regimens used, and the adverse events associated with PEP was performed.
Results : During a five year-period, 820 episodes with occupational blood or body fluid exposures were
reported. Nurses (27%) were the largest group at risk. The most common type of exposure was percutaneous
injuries (82%). Only 125 (15%) HCWs had occupational exposures to HIV, 64 HCWs were prescribed HIV PEP
and 32 (50%) HCWs did not complete the PEP regimen as initially prescribed. The commonly prescribed ARV
was zidovudine (38%), lamivudine (33%), and indinavir (11%). Overall, 18 (28%) HCWs reported symptoms
while on PEP, such as nausea (89%), vomiting (55%), and dizziness (39%). None of the HCWs had HIV
seroconversion.
Conclusions : Adverse effects from HIV PEP were very common. Clinicians prescribing HIV PEP need to
discuss with HCWs about PEP efficacy and side effects. Education efforts aimed at occupational exposure
prevention are still important issues.
Keywords : HIV, Postexposure prophylaxis, Health care worker, Antiretroviral drug, Adverse event
