The Danish PEP Registry: Experience with the Use of Post-Exposure Prophylaxis Following Blood Exposure to HIV from 1999-2012
BACKGROUND:
The
risk of occupational exposures to blood cannot be eliminated completely and
access to post-exposure prophylaxis (PEP) to prevent HIV transmission is important. However, PEP
administration has been associated with frequent adverse effects, low compliance
and difficulties to ensure a proper risk assessment. This nationwide study
describes 14 years of experience with the use of PEP following blood exposure
in Denmark.
METHODS:
A
descriptive study of all PEP cases following non-sexual exposure to HIV in Denmark from 1999-2012.
RESULTS:
A total
of 411 cases of PEP were described. There was a mean of 29.4 cases/year,
increasing from 23 cases in 1999 to 49 cases in 2005 and then decreasing to 16
cases in 2012. Overall 67.2% of source patients were known to be HIV-positive
at the time of PEP initiation, with no significant change over time. The median
time to initiation of PEP was 2.5 h (0.15-28.5) following occupational
exposure. Adverse effects were reported by 50.9% with no significant difference
according to PEP regimen. In 85.1% of cases with available data, either a full
course of PEP was completed or PEP was stopped because the source was tested HIV-negative.
Only 6.6% stopped PEP early due to adverse effects.
CONCLUSIONS:
PEP
in Denmark is generally prescribed according to the guidelines and the annual
number of cases has declined since 2005. Adverse effects were common regardless
of PEP regimens used and new drug regimens should be considered.
- 1a Department of Pulmonary and Infectious Diseases , Nordsjælland Hospital , Hillerød , Denmark.
- 2b Department of Infectious Diseases , Rigshospitalet , Copenhagen , Denmark.
- 3c Department of Infectious Diseases , Hvidovre Hospital , Hvidovre , Denmark.
- 4d Department of Infectious Diseases , Skejby Hospital , Århus , Denmark.
- 5e Department of Infectious Diseases , Odense Hospital , Odense , Denmark.
- 6f Department of Infectious Diseases , Ålborg Hospital , Ålborg , Denmark.
- 7g Department of Medicine , Herning Hospital , Herning , Denmark.
- 8h Medical Faculty, Copenhagen University , Copenhagen , Denmark.
- 9i Department of Medicine , Kolding Hospital , Kolding , Denmark.
- Infect Dis (Lond). 2016 Mar;48(3):195-200. doi: 10.3109/23744235.2015.1103896. Epub 2015 Nov 3.
No comments:
Post a Comment