title: [HIV post exposure prophylaxis therapy - the experience of two major AIDS centers].
abstract: BACKGROUND
  During recent years, the use of antiretroviral therapy expanded beyond the treatment of HIV-infected patients. Since the outset of the HIV epidemic, antiretroviral drugs were also used for post-exposure prevention of HIV infection in health workers and implemented after possible exposure during sex. In this study, we summarize the cases from the AIDS center in the Kaplan Medical Center and the Sheba Medical Center after possible exposure to HIV (occupational or sexual).
  
  
  OBJECTIVE
  The study aims to validate the different types of potential exposures to HIV encountered, the treatment and outcomes.
  
  
  METHODS
  All the data regarding attendance at the AIDS Center in the Kaplan Medical Center during the years 2008-2010 for any possible HIV exposure (occupational or sexual) and for sexual exposure in the Sheba Medical Center AIDS Clinic during the years 2003-2008 was collected retrospectively.
  
  
  RESULTS
  During the years of the study, 448 patients attended the Kaplan Medical Center for consultation after a potential exposure to HIV; 314 of the cases were because of occupational exposure, however, only in 11 (3.5%) of the cases, post exposure prophylaxis (PEP) treatment was advised. In the other 134 patients who attended for non-occupational potential exposure to HIV (18 cases of needle stick or sharp object injury and 116 of sexual exposure), for 46 (40%) of these cases, PEP was recommended. No evidence of HIV infection was found for any of the 448 patients who attended the clinic for possible exposure to HIV, regardless of the consultation that they received. In the Sheba Medical Center, during the years 2003-2008, 175 patients attended for consuLtation after potential sexual exposure to HIV. The medical staff of the clinic decided, after risk assessment, to recommend PEP to 140 (80%) of the cases. Similarly, in this case, no evidence of HIV infection was found (regardless of whether PEP was given or not).
  
  
  CONCLUSIONS
  In potential occupational exposure to HIV it is possible, in most cases, to assess the risk for infection sufficiently so that only a few cases will need PEP. In potential sexual exposure to HIV, there are many cases where data regarding the potential source of infection is partial or missing, making the risk assessment more difficult. This may be the reason for the high percentage of patients in this situation who received PEP. From the data in this study, our cohort support PEP as being effective and safe.
authors.affiliation: Internal Medicine B and the Altergy, Clinical Immunology and AIDS Unit, Kaplan Medical Center, Rehovot affiliated to the Medical School, Hebrew University, Hadassah, Jerusalem.
authors.forename: Daniel
authors.initials: D
authors.lastname: Elbirt
authors.forename: Itzhak
authors.initials: I
authors.lastname: Levy
authors.forename: Ilan
authors.initials: I
authors.lastname: Asher
authors.forename: Keren
authors.initials: K
authors.lastname: Mahlev-Guri
authors.forename: Shira
authors.initials: S
authors.lastname: Rosenberg-Bezalet
authors.forename: Slava
authors.initials: S
authors.lastname: Litachevsky
authors.forename: Sara
authors.initials: S
authors.lastname: Radian-Sade
authors.forename: Zev
authors.initials: Z
authors.lastname: Sthoeger
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D015497:HIV-1; D006282:Health Personnel; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control / Q000706:statistics & numerical data; D007557:Israel / Q000453:epidemiology; D008297:Male; D016602:Needlestick Injuries / Q000453:epidemiology; D009784:Occupational Diseases / Q000517:prevention & control; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care; D056990:Post-Exposure Prophylaxis / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012747:Sexual Partners; D047568:Unsafe Sex / Q000706:statistics & numerical data*
chemical_list: D019380:Anti-HIV Agents