title: A randomised prospective study to evaluate a rapid HIV-antibody assay in the management of cases of percutaneous exposure amongst health care workers.
abstract: A rapid start of post-exposure prophylaxis with an antiretroviral regime is recommended after percutaneous exposure to blood from an HIV-positive source. Since the HIV-antibody status of the source is usually not known at the time of injury, antiretroviral treatment is started pending the results of HIV testing of the source. A randomised prospective study was designed to compare the use of a rapid-screening assay in the management of cases of percutaneous exposure with the conventional procedure. Prior to the comparative study, the accuracy of a rapid-screening assay performed by non-laboratory trained personnel was evaluated. 123 blinded HIV-positive and HIV-negative samples were correctly identified. In a randomised comparison with the conventional procedure, the application of the rapid-screening assay resulted in a significant reduction of psychological stress, drug use and cost. The estimated net benefit per case was CHF 93.-(62 US$). This study strongly supports the use of the rapid-screening assay in the management of post-exposure prophylaxis for HIV after percutaneous exposure in health care workers.
authors.affiliation: Department of Internal Medicine, Kantonsspital St. Gallen, Switzerland.
authors.forename: A M
authors.initials: AM
authors.lastname: King
authors.forename: J J
authors.initials: JJ
authors.lastname: Osterwalder
authors.forename: P L
authors.initials: PL
authors.lastname: Vernazza
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000097:blood / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D016273:Occupational Exposure / Q000191:economics; D010564:Personnel, Hospital; D011446:Prospective Studies; D015203:Reproducibility of Results; D016037:Single-Blind Method; D012867:Skin; D013315:Stress, Psychological / Q000517:prevention & control; D013557:Switzerland
chemical_list: D019380:Anti-HIV Agents; D015483:HIV Antibodies