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性接触后HIV暴露后预防:对照英国性健康和HIV协会(BASHH)近期的指南草案进行的回顾性审计

Post-exposure HIV prophylaxis following sexual exposure: a retrospective audit against recent draft BASHH guidance.

作者信息

Day S, Mears A, Bond K, Kulasegaram R

机构信息

Lydia Department, St Thomas's Hospital, Lambeth Palace Road, London SE1 7EH, UK.

出版信息

Sex Transm Infect. 2006 Jun;82(3):236-7. doi: 10.1136/sti.2005.017764.

Abstract

OBJECTIVES

To retrospectively audit the management of post-exposure HIV prophylaxis following sexual exposure (PEPSE) against the British Association for Sexual Health and HIV 2004 draft guidance.

METHODS

A retrospective review of case notes from January 2000 to November 2004. The draft guidelines were not adopted into clinical practice during the study period.

RESULTS

76 patients received PEPSE. 79% (95% CI 68.08 to 87.46) of PEPSE prescriptions were given for exposures that were in accordance with the guidelines' recommended indications (target 90%). 87% (95% CI 77.13 to 93.51) of PEPSE was prescribed within 72 hours of risk exposure (target 90%). 91% (95% CI 81.94 to 96.22) of recipients received a recommended antiretroviral combination. 53% (95% CI 40.84 to 64.21) of recipients completed the PEPSE course (target 75%). 45% of patients attended for the 3 month follow up HIV test but only 12% (95% CI 5.56 to 21.29) attended for both the 3 month and 6 month HIV test (target 75%).

CONCLUSION

PEPSE is predominantly being prescribed for recommended indications and is dispensed within 72 hours of risk exposure. PEPSE completion rates and attendance for 3 months and 6 months post-exposure HIV testing need improving, perhaps by introducing a PEPSE clinic.

摘要

目的

根据英国性健康与艾滋病协会2004年的指导草案,对性接触后艾滋病病毒暴露后预防(PEPSE)的管理进行回顾性审核。

方法

对2000年1月至2004年11月的病历进行回顾性研究。在研究期间,该指导草案未被纳入临床实践。

结果

76例患者接受了PEPSE。79%(95%可信区间68.08至87.46)的PEPSE处方用于符合指南推荐指征的暴露情况(目标为90%)。87%(95%可信区间77.13至93.51)的PEPSE在风险暴露后72小时内开具(目标为90%)。91%(95%可信区间81.94至96.22)的接受者接受了推荐的抗逆转录病毒联合用药。53%(95%可信区间40.84至64.21)的接受者完成了PEPSE疗程(目标为75%)。45%的患者进行了3个月的暴露后艾滋病毒检测随访,但只有12%(95%可信区间5.56至21.29)的患者进行了3个月和6个月的艾滋病毒检测随访(目标为75%)。

结论

PEPSE主要针对推荐指征开具,并在风险暴露后72小时内配药。PEPSE的完成率以及暴露后3个月和6个月艾滋病毒检测的随访率需要提高,或许可以通过设立PEPSE诊所来实现。

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