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International Journal of STD & AIDS

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Int J STD AIDS 2002;13:30-34
doi:10.1258/095646202762226137
© 2002 Royal Society of Medicine Press

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Articles

Post-exposure prophylaxis

Marchina E van der Ende, Rosa M Regez, Gerrit Schreij, Jan T M van der Meer, Sven A Danner and on behalf of the Dutch PEP registration

Department of Internal Medicine, Eramus MC, Rotterdam, The Netherlands; Onze Lieve Vrouwe Gasthuis, Amsterdam, Department of Internal Medicine, Amsterdam, The Netherlands; University Hospital Maastricht, Department of Internal Medicine, Amsterdam, The Netherlands; Academic Medical Centre, Amsterdam, Department of Internal Medicine, Amsterdam, The Netherlands; Free University Amsterdam, Department of Internal Medicine, Amsterdam, The Netherlands

The mean risk of acquiring HIV after an occupational exposure, injecting drug use or sexual exposure varies from <0.1 to 3%. A high plasma HIV-RNA of the source increases the risk of each of the exposures. Other factors, such as the volume of the inoculum involved to which the individual was exposed, other sexually transmitted diseases and ruptures of mucous membranes are associated with a higher risk of HIV transmission. Based on the calculated risk, post-exposure prophylaxis (PEP) should be recommended. In the Netherlands, prescription of PEP in the occupational setting is a standard procedure and has proved to be feasible. This was associated with a high percentage (62%) of mild and reversible toxicity and a small percentage (2%) of serious adverse events related to antiretroviral drugs, i.e. nephrolithiasis (due to indinavir) and toxic hepatitis (due to nevirapine). In The Netherlands so far no HIV-seroconversions have been recorded after an occupational accident.

Key Words: OCCUPATIONAL PROPHYLAXIS • POST-EXPOSURE PROPHYLAXIS • ANTI-HIV CHEMOPROPHYLAXIS • NEEDLE STICK ACCIDENT • HIV TRANSMISSION


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