[Recommendations for non-occupational postexposure HIV prophylaxis. Spanish Working Group on Non-Occupational Postexposure HIV Prophylaxis of the Catalonian Center for Epidemiological Studies on AIDS and the AIDS Study Group].
Evidence is lacking on the possible efficacy and effectiveness of non-occupational postexposure prophylaxis (PEP). However, because of its biological plausibility, the use of antiretroviral (ARV) drugs to prevent the development of infection in certain cases of accidental or sporadic exposure has begun to be considered as common clinical practice. Previous studies performed in Spain have demonstrated both the demand and the prescription of ARV as PEP and especially the diversity and inconsistency in the criteria used. In this context, in April of 2000 the Centre for Epidemiological Studies on AIDS of Catalonia (CEESCAT) (Department of Health and Social Security of the Autonomous Government of Catalonia), in collaboration with the National AIDS Plan and the AIDS Study Group (GESIDA), promoted the creation of a working group for the drafting of recommendations for PEP against HIV outside the occupational health context. The recommendations have been made bearing in mind the exceptional character of the exposure, the time elapsed since exposure, as well as evaluation of the risk of infection according to the type of exposure and the information available on the source of infection. In addition, the recommendations include the immediate measures necessary, as well as the preventive measures and clinical follow-up required both for HIV and for other infectious agents. All PEP regimens should be started within 72 hours of exposure and appropriate daily doses of two nucleoside reverse transcriptase inhibitors (NRTIs) and a protease inhibitor (PI), or two NRTIs and a non-nucleoside reverse transcriptase inhibitor (NNRTIs), should be administered for four weeks, bearing in mind the pharmacological and clinical situation of the source person. These recommendations should be updated periodically.
Almeda
Jesús
J
Centre de Estudis Espidemiològics sobre la Sida a Catalunya. Hospital Universitari Germans Trias i Pujol. Badalona. España. jalmeda@ceescat.hugtip.scs.es
Casabona
Jordi
J
Allepuz
Alejandro
A
García-Alcaide
Felipe
F
del Romero
Jorge
J
Tural
Cristina
C
Colm
Joan
J
Bolao
Ferrán
F
Campins
Magda
M
Domínguez
Angela
A
Force
Lluís
L
Giménez
Albert
A
Guerra-Romero
Luis
L
D000328:Adult; D000465:Algorithms; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D015897:Comorbidity; D016358:Contact Tracing; D004781:Environmental Exposure; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D006509:Hepatitis B / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D007258:Informed Consent; D008297:Male; D016485:Needle Sharing; D011902:Rape; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D013030:Spain; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D013997:Time Factors
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors