Expanded postexposure prophylaxis for simultaneous multiple source HIV exposure in a health-care worker.
We report an extreme case of high-grade needlestick exposure of a health-care worker to serum from multiple HIV-infected patients after trying to prematurely remove the respective tubes from an automated biochemical analyser. After review of the medical records of the eight source patients, we offered the health-care worker an expanded postexposure prophylaxis regimen including the entry inhibitor enfuvirtide. She refused to take subcutaneous injections, so we recommended the use of the integrase inhibitor raltegravir. She completed therapy without problems and periodic evaluation for HIV transmission up to nine months after the incident was negative.
Baraboutis
I G
IG
Division of Infectious Disease and HIV, 5th Department of Internal Medicine, Evaggelismos General Hospital, Ipsilantou 45-47, 10676 Athens. ioannisbaraboutis@yahoo.gr
Papastamopoulos
V
V
Georgiou
O
O
Samarkos
M
M
Vrionis
E
E
Kotsianopoulou
M
M
Skoutelis
A T
AT
D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active; D000069454:Darunavir; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000068679:Emtricitabine; D000077560:Enfuvirtide; D005260:Female; D005385:Fingers; D015700:HIV Envelope Protein gp41 / Q000008:administration & dosage; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008875:Middle Aged; D016602:Needlestick Injuries; D009784:Occupational Diseases / Q000517:prevention & control* / Q000821:virology; D063065:Organophosphonates / Q000008:administration & dosage; D010446:Peptide Fragments / Q000008:administration & dosage; D056990:Post-Exposure Prophylaxis / Q000379:methods*; D019438:Ritonavir / Q000008:administration & dosage; D013449:Sulfonamides / Q000008:administration & dosage; D000068698:Tenofovir
D019380:Anti-HIV Agents; D015700:HIV Envelope Protein gp41; D063065:Organophosphonates; D010446:Peptide Fragments; D013449:Sulfonamides; D003841:Deoxycytidine; D000077560:Enfuvirtide; D000068698:Tenofovir; D000068679:Emtricitabine; D000225:Adenine; D019438:Ritonavir; D000069454:Darunavir