CHARACTERISTICS OF DEMAND AND PRESCRIPTION OF NON OCCUPATIONAL HIV POST EXPOSURE PROPHYLAXIS NONOPEP

1
CHARACTERISTICS 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)
2
BACKGROUND
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.
3
EURO-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.
4
OBJECTIVES
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.
5
METHODS
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

6
RESULTS 901 cases from January 4th 2001 to
June 17th 2002
7
CHARACTERISTICS 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)
8
TYPE 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)
9
SOURCE HIV STATUS AT BASELINE RELATED TO THE TYPE
OF EXPOSURE
10
ART PRESCRIBED BY RISK CATEGORIES
11
DRUG REGIMENS
12
CONCLUSIONS

• 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.

13
CONCLUSIONS

• 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.

14
ACKNOWLEDGEMENT
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