Article Text

Download PDFPDF

5PSQ-142 Evaluation of adequacy, adherence and safety of human immunodeficiency virus post-exposure treatment
  1. S Álvarez Atienza1,
  2. I Salvador Llana1,
  3. P Sanmartin Fenollera1,
  4. JE Losa Garcia2,
  5. M Perez Encinas1
  1. 1Hospital Universitario Fundación Alcorcón, Pharmacy, Alcorcón, Spain
  2. 2Hospital Universitario Fundación Alcorcón, Infectious Diseases, Alcorcón, Spain

Abstract

Background and Importance Preventing human inmunodeficiency virus(HIV) transmission is a major public health challenge. Consideration is given to the role of post-exposure treatment(PEP) of HIV prevention strategies.

Aim and Objectives To describe the adequacy, adherence and safety of PEP.

Material and Methods A retrospective observational study conducted in a tertiary hospital: patients older than16 years old treated with PEP who consulted to emergency department(ED) January2021-july2022. Sex, age, risk and type exposure, adequacy of PEP based in clinical guidelines (<72 hours to start PPE, combination:EMTRICITABINE/TENOFOVIR/RALTEGRAVIR), previous PEP, HIV-status source, basal/monthly serology, dispensing-shift, suitable patient for pre-exposure treatment(PrEP), adherence, completeness and safety of PEP were collected as variables. Statistical analysis was performed using Stata MPv17.0.

Results 70 patients(67.14% men; median age 24.44, Interquartile range[IQR:21.69–35.91]) visited de ED 77 times to get PEP: 5/70(7.14%) presented twice and 1/70(1.43%) three times. 13/70(18.57%) were suitable to start PrEP and 1/13 had already started PrEP.

67/77(87.01%) of dispensing treatment were carried out in our centre and 70/77(90.90%) were the standard combinations. Exposure risk were: 36/77(46.75%) low, 32/77(41.56%) minimum, 7/77(9.09[CU1]%) high and 2/77(2.60%) unknown. Of all, only 3/77(3.89%)PEP were not adequate according clinical guidelines. All patients were provided by pharmaceutical care and a large proportions of all PEP visits 46/77(59.74%) were between 10pm-8am.

75/77(97.40%) of exposure were non-occupational: 54/75(72%) sexual exposure, 18/75(24.00%) suspected sexual aggression and 3/75(4.00%) accidental puncture. Most of HIV-status of the source were unknown(63/77;81.82%), followed by positive status(12/77;15.58%) and negative status (2/77;2.60%). HIV serologies at the baseline were negatives(72/77) or unknown(4/77) except 1 who had positive status. In the monthly serology, most of the patients had a negative result(55/76) or unknown due to loss of follow-up(LFU)(21/76).

After finishing PEP, 60/77(77.92%) patients had adherence, 8/77(10.39%) had no-adherence and 12/77(15.58%) unknown because of LFU.

21/77(27.27%) PEP were not finished due to LFU(15/21;71.43%), medical decision (5/21;23.81%) or treatment intolerance(1/21;4.76%).

Side effects(SE) were reported in 24/77(31.17%):(4;16.66%) patients reported moderate SE[CU2].

Abstract 5PSQ-142 Table 1

Conclusion and Relevance In summary, PEP decision-making was adequate in the majority of visits. It should be noted the large number of patients who are LFU[CU1] . Therefore, work should be done to avoid such losses.

Conflict of Interest 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.