[HIV/AIDS prophylaxis following exposure].
CURRENT PRACTICE: The use of anti-retrovirals in post-exposure prophylaxis has progressed tremendously in France since 1988. The ministerial recommendations of April 1988 were based on the results of a case-control study demonstrating that administration of zidovudine reduces by 80% the risk of contamination in nursing staff giving injections. Today, the tendency is to prescribe chemoprophylaxis when eventual blood or sexual contact with HIV is probable. UNCERTAINTY AND LIMITS: Every year in France, thousands of treatments are prescribed, without any possibility of measuring their impact on preventing the transmission of HIV. The side effects of such prescriptions are considerable and emphasize the importance of limiting the indications to cases in which the risk is documented, immediately after exposure, and with appropriate medical monitoring. PRACTICAL METHODS: The management system of exposure to HIV is organized in hospitals where an emergency unit exists, and relies on competent physicians trained in the handling of anti-retrovirals. Surveillance of the prescriptions and subsequent monitoring is organized by the "Institut national de veille sanitaire" (InVS) (National institute of health monitoring). The usual therapeutic strategies propose two nucleoside analogs and, increasingly, a protease inhibitor.
Bouvet
Elisabeth
E
Service des maladies infectieuses et tropicales A, Hôpital Bichat-Claude-Bernard, 46, rue Henri Huchard, 75877 Paris. elisabeth.bouvet@bch.ap-hop-paris.fr
D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control* / Q000635:transmission; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D004632:Emergency Medical Services; D005602:France; D006291:Health Policy; D006801:Humans; D017410:Practice Guidelines as Topic; D015215:Zidovudine / Q000627:therapeutic use*
D019380:Anti-HIV Agents; D015215:Zidovudine