AEGiS-14IAC: Proposed European Recommendations for Post-Exposure Prophylaxis against HIV infection in Health Care Workers.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Proposed European Recommendations for Post-Exposure Prophylaxis against HIV infection in Health Care Workers.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. LbOr01B)

Puro V, Cicalini S, Schonwald S, Balslev U, Lot F, Marcus U, Boaventura JL, Campins M, Bernasconi E, Thomas T, De Carli G, Ippolito G; INMI Spallanzani, Rome, Italy

BACKGROUND: Management of occupational HIV post-exposure prophylaxis (PEP) varies among European countries, and several issues remain controversial.

METHODS: In September 2001, the European Commission funded a project to standardise the management of occupational HIV PEP in Europe. During a 2-day consensus meeting, expert representatives from Italy, Croatia, Denmark, United Kingdom, France, Germany, Portugal, Spain, Switzerland reviewed and discussed available National recommendations and policies, data from local surveillance programs and current literature, thus issuing a consensus document.

RESULTS: The consensus document recommends that all efforts should be made to prevent occupational exposures. PEP prescription should be based on the type of exposure, body material involved and source patient's evaluation. After the source patient's consent to HIV testing, ?immediate? results should be obtained in order to prevent unnecessary PEP, also by using rapid HIV-antibody tests. PEP should be initiated as soon as possible and is discouraged after 72 hours from exposure. A 4-week course of any combination of antiretrovirals approved for the treatment of HIV patients could be used in a PEP regimen. Triple therapy (i.e. 2 NRTI + 1 PI or 1 NNRTI) is recommended as a first line PEP regimen. The source patient?s history about previous and current antiretroviral treatments may be important in the choice of PEP regimen. HIV testing should be performed shortly after exposure and thereafter at 6 weeks, 3 and 6 months. The routine use of direct virus assays (HIVp24Ag, HIV-RNA) in an exposed healthcare worker is not recommended. Drug adherence and tolerability should be monitored.

CONCLUSIONS: A standardized management of PEP in EU countries could effectively improve occupational safety in the healthcare setting, in increasing our understanding of efficacy and toxicity of antiretroviral drugs and optimising the use of available resources to reduce the risk of HIV infection.

Keywords: AEGIS, HIV Infections, Health Personnel, Anti-HIV Agents, Health Planning Guidelines, HIV, Antiretroviral Therapy, Highly Active, Occupational Exposure, Drug Therapy, Combination, Europe, France, Italy, Portugal, Spain, Germany, Great Britain, Switzerland, Croatia, Denmark, Human, prevention & control, therapy, drug therapy

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