Title: CHARACTERISTICS OF DEMAND AND PRESCRIPTION OF NON OCCUPATIONAL HIV POST EXPOSURE PROPHYLAXIS NONOPEP
1CHARACTERISTICS OF DEMAND AND PRESCRIPTION OF NON
OCCUPATIONAL HIV POST EXPOSURE PROPHYLAXIS
(NONOPEP) IN EUROPEB. G. Simon for the
EURO-NONOPEP ProjectCentre of Epidemiological
Studies on HIV/AIDS of Catalonia (CEESCAT)
2BACKGROUND
Rationale for NONOPEP - Biological
plausibility. - Studies of effectiveness on PEP
in animals. - Effectiveness of PEP for HCWs. -
Efficacy of mother-to-child transmission
prophylaxis. - Studies on NONOPEP
cost-effectiveness. - Demand not negligible in
Europe.
3EURO-NONOPEP European Project on Non
Occupational Post-exposure Prophylaxis for HIV.
(European Commission. Directorate-Generale
Health and Consumer Protection) PURPOSE To
monitor NONOPEP practices in Europe by means of a
prospective Registry for individuals after a
potential HIV non occupational exposure. 14
participant countries. Coordinator Center
CEESCAT.
4OBJECTIVES
To describe the epidemiological characteristics
of the potentially exposed individuals. To
describe the risk assessment and the pattern of
the ART prescription. To describe the clinical
and biological follow-up of the enrolled
individuals.
5METHODS
INCLUSION CRITERIA Individuals consulting for a
potential non occupational exposure to HIV. DATA
COLLECTED At baseline, at 1 month and at 6 month
follow up - Demographic data - Type and
Circumstances of the exposure -
Characteristics of source person - Risk
assessment - ART prescribed - Follow up
adherence, side effects, seroconversion
6RESULTS 901 cases from January 4th 2001 to
June 17th 2002
7CHARACTERISTICS OF THE EXPOSED INDIVIDUALS
901 Men 588 (65.2) Women 307
(34.1) Transsexuals 6 ( 0.7)
Median age 30 y. (5
months - 76 years) Cases with previous
exposures 281/901 (31) Median time from
exposure to the initial consultation
17 h. (5 min 2.5 months)
8TYPE OF EXPOSURES Sexual 532 (59)
Heterosexuals 367 (69)
Homosexuals 160 (30)
Transsexuals 5 (
1) Parenteral 258 (29) Accidental needle
stick 206 (80) Aggressions
36 (14) Sharing IDU
material 16 ( 6) Others
111 (12) Blood contact with non intact skin
46 (42) Human bite wounds
38 (34) Blood contact with mucous m.
11 (10) Blood contact with intact skin
5 ( 4)
Unknown 11
(10)
9SOURCE HIV STATUS AT BASELINE RELATED TO THE TYPE
OF EXPOSURE
10ART PRESCRIBED BY RISK CATEGORIES
11DRUG REGIMENS
12CONCLUSIONS
- More than half of the exposures were sexual.
However - we noted a not negligible number of atypical
exposures. - One third of the exposed individuals declared
similar - previous exposures.
- Most often, the source person HIV status was
unknown. - In spite of a majority of at low risk exposures,
one third of them received an ART prescription.
13CONCLUSIONS
- These data underline the difficulties to define
and imple- - ment NONOPEP cost effective practices.
-
- The number of recruited individuals during one
year and - the 1 month follow up rate, reinforce the
feasibility of - the European NONOPEP registry.
- Although it will be difficult to assess its
effectiveness, - the Registry will be useful to describe and to
monitor - NONOPEP practices in Europe.
14ACKNOWLEDGEMENT
BELGIUM N Clumeck M Gerard DENMARK E Smith S
Lunding GREECE M Lazanas N Mangafas PORTUGAL
A Mota Miranda J Aguiar F Antunes J
Boaventura L Caldeira N Faria N Garrido C Lima S
Meliço J Oliveira A Pereira N Ribeiro A
Ribeiro E Valadas
ITALY V Puro Z Mariano G De Carli N Orchi V
Galati E Nicastri Z Lazarevic SLOVENIA J
Tomazic E Grilc T Jurca G Lenièar M Matièiè S
Pavliniè Mirjana N Pirnat UNITED KINGDOM B
Evans K Sadler P Benn IRELAND C Bergin E
Brannigan
SWITZERLAND E Bernasconi C Bellini B Bernasconi C
Chuard C Colombo P Francioli J Furrer V Gurtner
B Hirschel L Magenta HC Ruef A Telenti P
Vernazza T Waggels NETHERLANDS A Van den Hoek M
Mol G Sonder R Regez FRANCE Y Obadia D Rey K
Bendiane P Enel L Bentz
SPAIN J Casabona J Almeda A Arranz F Asensis E
Barbe F Bella M Campins J Colomer D Dalmau L
Force F García I García A Guelar J Otero E
Pedrol F Pulido JM Ramon I Santos MJ Téllez J
del Romero C Tural J Vergas GERMANY Marcus
Ulrich