title: Lipid abnormalities in a healthcare worker receiving HIV prophylaxis.
abstract: Healthcare workers (HCWs) worldwide risk occupational exposure to HIV and other blood-borne pathogens. Post-exposure prophylaxis (PEP) may decrease the risk of seroconversion after occupational or sexual exposure. Current guidelines recommend immediate PEP with at least 2 drugs following HIV exposure. In high-risk exposures, the guidelines recommend the use of a protease inhibitor (PI) as well as 2 reverse transcriptase inhibitors. Protease inhibitors have been associated with dyslipidaemias, other metabolic abnormalities and lipodystrophy syndromes in AIDS patients. We report a case of new transient lipid abnormalities in a HCW receiving PEP after HIV exposure. HIV medications may produce occult metabolic abnormalities in HIV-negative individuals receiving PEP. This risk should be considered during follow-up evaluation for PEP.
authors.affiliation: Division of Occupational Medicine, Department of Emergency Medicine, University of Pennsylvania Health System, One Silverstein Pavilion, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Allan
authors.forename: A J
authors.initials: AJ
authors.lastname: Behrman
mesh_terms: D000328:Adult; D000488:Allied Health Personnel; D019380:Anti-HIV Agents / Q000009:adverse effects*; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004338:Drug Combinations; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000139:chemically induced*; D019259:Lamivudine / Q000009:adverse effects*; D016602:Needlestick Injuries / Q000150:complications*; D019888:Nelfinavir / Q000009:adverse effects*; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis / Q000295:instrumentation*; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects*; D015215:Zidovudine / Q000009:adverse effects*
chemical_list: D019380:Anti-HIV Agents; D008078:Cholesterol, LDL; D004338:Drug Combinations; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; C109078:lamivudine, zidovudine drug combination; D019259:Lamivudine; D015215:Zidovudine; D002784:Cholesterol; D019888:Nelfinavir