Article Text

PDF

CPC-043 Effectiveness and Change of the Protocol For Antiretroviral Treatment Following Exposure to HIV
  1. M García Queiruga,
  2. C Vilaboa Pedrosa,
  3. L Martínez López,
  4. M Zas García,
  5. L Margusino Framiñán,
  6. I Martín Herranz
  1. Complejo Hospitalario Universitario A Coruña, Pharmacy, A Coruña, Spain

Abstract

Background The average risk of infection after occupational exposure to HIV is 0.3% (0.2–0.5% percutaneous exposure, 0.01–0.5% contact with mucous or non-intact skin) and after sexual exposure 0.01–3%, depending on sexual practise.

An action protocol has been in place at our centre since 2010, based on international recommendations for exposure to HIV that include:

  1. Start treatment within 72 hours post-exposure.

  2. 1st choice guideline: Tenofovir/Emtricitabine+Lopinavir/Ritonavir regimen or the source treatment if viral load is controlled; 2nd choice Tenofovir/Emtricitabine or Lamivudine/Zidovudine+protease inhibitor(PI), boosted with Ritonavir.

  3. Length of treatment: 30 days.

  4. Serological analysis at different points until the 6th month.

Before 2010, the hospital followed the international recommendations, with 1st choice Tenofovir/Emtricitabine or Lamivudine/Zidovudine+PI boosted with Ritonavir.

Purpose To evaluate the effectiveness and change to the protocol currently in force since 2010 and that of the previous international recommendations, following exposure to HIV.

Materials and Methods A retrospective observational study. Sample: 100% of patients with antiretroviral treatment following exposure. Period: January 2000-June 2012. Data Sources: Pharmacotherapy records (Silicon computer programme) and electronic medical records (IANUS application). Variable effectiveness: absence of seroconversion in exposed patient following post-exposure prophylactic treatment (PEPT). Analysis on: day-0, month-1, month-3 and month-6.

Results 33 patients. Average age 37.3(23–65), 13 males (39.4%). Patients treated with first choice: 94%, other therapeutic options: 6.0%. 90.9% of patients received treatment for 30 days. 38.2% of patients underwent correct serological monitoring until 6 months, 52.9% until 3 months. 96.9% started treatment within 72 hours of exposure. All baseline serologies were negative and there were no cases of seroconversion. Average cost/patient €747.

Conclusions PEPT was able to achieve the therapeutic goal in all study patients. The treatment chosen and the time of beginning after exposure were correct. The follow-up until 6 months was not carried out correctly in a significant percentage of patients. These facts and the high costs, require close pharmacotherapy monitoring of these patients.

No conflict of interest.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.