HIV prone occupational exposures: epidemiology and factors associated with initiation of post-exposure prophylaxis

2009 ◽  
Vol 63 (5) ◽  
pp. 373-378 ◽  
Author(s):  
D. Zenner ◽  
S. Tomkins ◽  
A. Charlett ◽  
K. Wellings ◽  
F. Ncube
Keyword(s):  
Occupational Exposures ◽  
Post Exposure Prophylaxis ◽  
Factors Associated ◽  
Post Exposure ◽  
Exposure Prophylaxis

Delayed rabies post-exposure prophylaxis treatment among Dutch travelers during their stay abroad: a comprehensive analysis

2021 ◽  
Author(s):  
Loes Verdoes ◽  
Floriana S Luppino ◽  
Jacco Wallinga ◽  
Leo G Visser
Keyword(s):  
Post Exposure Prophylaxis ◽  
Travel Destination ◽  
Factors Associated ◽  
Post Exposure ◽  
Associated Injury ◽  
Immune Globulins ◽  
Study Population ◽  
Sample Characteristics ◽  
Exposure Prophylaxis ◽  
Main Factor

Abstract Background After an animal-associated injury (AAI) in rabies-endemic regions, post-exposure prophylaxis (PEP) is needed to prevent infection.1,3 PEP consist of rabies vaccinations (RV) and in some cases also additional rabies immune globulins (RIG). Not always PEP medication, and RIG in particular, is accessible. Along with an increased number of exposure notifications among Dutch travelers, this might lead to treatment delay, and thus to increased health risks. Until now, research mainly focused on factors associated with exposition, but none on which factors are associated with PEP delay. This study aimed to identify which general sample characteristics are associated with PEP delay while being abroad. Methods A quantitative retrospective observational study was conducted. The study population consisted of insured Dutch international travelers who actively contacted their medical assistance company (2015-2019) because of an animal-associated injury (AAI) (N = 691). The association between general sample characteristics and delay of different PEP treatments was studied using survival analysis. Results Travelers without PrEP had an increased hazard, and therefore a shorter delay, for receiving their first RV as compared to travelers with PrEP (HR:1.11, 95%CI:1.01-1.22). The travelers needing both RV and RIG had a decreased hazard, and therefore a longer delay, as compared to travelers only needing RV (HR:0.81, 95%CI:0.67-0.96). General sample characteristic associated with RIG administration delay was travel destination. Travelers to Central and South America, East Mediterranean and Europe had a decreased hazard, and therefore a longer delay, for receiving RIG treatments relative to travelers to South East Asia (HR:0.31, 95%CI:0.13-0.70; HR:0.34, 95%CI:0.19-0.61; HR:0.46, 95%CI:0.24-0.89; HR:0.48, 95%CI:0.12-0.81 respectively). Conclusions Our results suggest that the advice for PrEP should be given based travel destination, as these was found to be the main factor for PEP delay, among travelers going to rabies endemic countries.

scholarly journals Occupational exposure to HIV and use of post-exposure prophylaxis in a general hospital in North Central, Nigeria.

2013 ◽  
Vol 3 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Abiola O Olaleye ◽  
Olorunfemi A Ogundele ◽  
Babatunde I Awokola ◽  
Oladele S Olatunya ◽  
Omolara A Olaleye ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
General Hospital ◽  
Health Workers ◽  
Central Zone ◽  
Occupational Exposures ◽  
Post Exposure Prophylaxis ◽  
North Central ◽  
Post Exposure ◽  
Exposure Prophylaxis

Occupational exposures to blood borne pathogens including HIV have been well studied. However, limited studies exist about the utilization of post exposure prophylaxis and follow-up in Nigeria. The objectives of the study were to describe the characteristics of occupational exposure to HIV, the utilization of post exposure prophylaxis (PEP) among health workers, and the proportion of exposed health workers reporting for follow-up three months after exposure. A cross sectional descriptive study involving ninety three health workers was carried out at a general hospital located in an urban area in North Central zone of Nigeria. A simple random sampling technique was used. The prevalence of occupational exposure, utilization of post exposure prophylaxis and follow-up rate were assessed using self administered questionnaire. Data analysis was done using SPSS version 16 and descriptive analysis was carried out. It was reported that, 73.1% of respondents at least one or more occupational exposures to HIV and other blood borne pathogens through accidental needle injury/prick, blood splash on a fresh wound or conjunctiva exposure in the last one year. Needle stick injury occurred in 83.8% of all respondents who had occupational exposures. 8.8% of exposed respondents commenced post exposure prophylaxis with two-thirds completing the post exposure prophylaxis regimen. Only one (25%) of those who completed the regimen reported for follow-up. Occupational exposures to HIV are common among health workers. The rates of utilization of post exposure prophylaxis and follow-up were low.   DOI: http://dx.doi.org/10.3126/ijosh.v3i1.6635   International Journal of Occupational Safety and Health, Vol 3 No 1 (2013) 11-17

scholarly journals Post exposure prophylaxis for HIV among healthcare workers due to occupational exposure: a record based study at a tertiary care teaching hospital of Kolkata

2021 ◽  
Vol 8 (5) ◽  
pp. 2503
Author(s):  
Paramita Sarkar ◽  
Saibendu Kumar Lahiri
Keyword(s):  
Occupational Exposure ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Occupational Exposures ◽  
Post Exposure Prophylaxis ◽  
Care Hospital ◽  
Skin Mucus ◽  
Needle Stick ◽  
Post Exposure ◽  
Exposure Prophylaxis

Background: Healthcare workers (HCWs) regularly face the risk of exposure to sharp injuries and splashes as an occupational hazard, which presents major risk for acquiring blood-borne infectious agents like human immunodeficiency virus (HIV) which can be minimized by taking post exposure prophylaxis (PEP) measures. There are limited studies from India documenting details of PEP for HIV. This record-based study aimed to determine the occurrence of needle stick injuries (NSIs) and other high-risk occupational exposures to blood and body fluids (BBFs) among HCWs in a tertiary care hospital, Kolkata. We aimed to study details of PEP regimens used among HCWs exposed to HIV.Methods: Hospital record was analyzed from reported incidences of occupational exposures to BBFs occurred during the period of October 2013 to March 2019. Information on self-reported incidence of occupational exposure, and post-exposure management were collected.Results: A total of 105 incidents of occupational exposure were registered during study period. Interns (37, 35.2%) were most frequently exposed, followed by physicians (22, 21.0%) and nurse (21, 20.0%). 88 (83.8%) of the personnel sustained NSIs, and 17 (7.2%) had splashes to skin, mucus membranes. There was no significant difference between subjects with splashes to skin, mucus membranes and needle-stick cases regarding discontinuation of post exposure prophylaxis (PEP) (11.8% versus 19.3%, p<0.548). No cases of sero-conversion were reported.Conclusions: In spite of high incidences of exposures to HIV source, good efficacy of PEP was observed with no sero-conversion. PEP for HIV was well tolerated. Study emphasized the need for creating awareness about timely reporting of incidence.

scholarly journals Factors associated with intention to take non-occupational HIV post-exposure prophylaxis among Thai men who have sex with men

2017 ◽  
Vol 3 (3) ◽  
pp. 128-139 ◽  
Author(s):  
Nitiya Chomchey ◽  
Thira Woratanarat ◽  
Narin Hiransuthikul ◽  
Somrat Lertmaharit ◽  
Vitool Lohsoonthorn ◽  
...  
Keyword(s):  
Post Exposure Prophylaxis ◽  
Factors Associated ◽  
Post Exposure ◽  
Sex With Men ◽  
Exposure Prophylaxis

scholarly journals Proposed recommendations for the management of HIV post-exposure prophylaxis after sexual, injecting drug or other exposures in Europe

2004 ◽  
Vol 9 (6) ◽  
pp. 5-6 ◽  
Author(s):  
J Almeda ◽  
J Casabona Barbarà ◽  
B Simon ◽  
M Gérard ◽  
D Rey ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Occupational Exposures ◽  
Population Group ◽  
Pathogen Transmission ◽  
Post Exposure Prophylaxis ◽  
Final Decision ◽  
National Guidelines ◽  
Post Exposure ◽  
Attitudes And Practices ◽  
Exposure Prophylaxis

Post-exposure prophylaxis (PEP) is the standard of care for a healthcare worker (HCW) accidentally exposed to an HIV infected source person (occupational exposure), but this is not the case for non-occupational exposures. Very few national guidelines exist for the management of non-occupational exposures to HIV in Europe, contrarily to the occupational ones. The administration of non-occupational post-exposure prophylaxis (NONOPEP) for HIV may be justified by: a biological plausibility, the effectiveness of PEP in animal studies and occupational exposures in humans, efficacy in the prevention of mother to child HIV transmission, and cost effectiveness studies. These evidences, the similar risk of HIV transmission for certain non-occupational exposures to occupational ones, and the conflicting information about attitudes and practices among physicians on NONOPEP led to the proposal of these European recommendations. Participant members of the European project on HIV NONOPEP, funded by the European Commission, and acknowledged as experts in bloodborne pathogen transmission and prevention, met from December 2000 to December 2002 at three formal meetings and a two day workshop for a literature review on risk exposure assessment and the development of the European recommendations for the management of HIV NONOPEP. NONOPEP is recommended in unprotected receptive anal sex and needle or syringe exchange when the source person is known as HIV positive or from a population group with high HIV prevalence. Any combination of drugs available for HIV infected patients can be used as PEP and the simplest and least toxic regimens are to be preferred. PEP should be given within 72 hours from the time of exposure, starting as early as possible and lasting four weeks. All patients should receive medical evaluation including HIV antibody tests, drug toxicity monitoring and counseling periodically for at least 6 months after the exposure. NONOPEP seems to be a both feasible and frequent clinical practice in Europe. Recommendations for its management have been achieved by consensus, but some remain controversial, and they should be updated periodically. NONOPEP should never be considered as a primary prevention strategy and the final decision for prescription must be made on the basis of the patient-physician relationship. Finally, a surveillance system for these cases will be useful to monitor NONOPEP practices in Europe.

scholarly journals New Canadian guideline provides evidence-based approach to non-occupational HIV prophylaxis

CJEM ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 21-25
Author(s):  
Shannon O’Donnell ◽  
Darrell H. S. Tan ◽  
Mark W. Hull
Keyword(s):  
Hiv Transmission ◽  
Occupational Exposures ◽  
Hiv Infections ◽  
Risk Exposure ◽  
Post Exposure Prophylaxis ◽  
Evidence Based ◽  
Post Exposure ◽  
Canadian Guideline ◽  
Key Points ◽  
Exposure Prophylaxis

AbstractThe incidence of HIV infections in Canada has increased yearly since 2014. New cases of HIV have resulted almost exclusively from non-occupational exposures, including sexual contact and needle sharing. Appropriate HIV post-exposure prophylaxis is under-prescribed to patients who present to the emergency department after a high-risk exposure. In November of 2017, a Canadian guideline on HIV pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP) was published. The guideline presents a standardized, evidence-based approach to assessing risk for HIV transmission and prescribing HIV prophylaxis. This summary highlights the key points from the guideline that are relevant to the practice of emergency medicine in Canada.

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