Hiransuthikul N, Hiransuthikul P, Kanasuk Y
Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Hosp Infect. 2007 Dec;67(4):344-9. doi: 10.1016/j.jhin.2007.09.014. Epub 2007 Nov 19.
This is a retrospective review of occupational exposure to human immunodeficiency virus (HIV) and subsequent postexposure prophylaxis (PEP) among healthcare workers (HCWs) in King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand. From January 2002 to December 2004, data were collected from incident reports, the hospital's infectious diseases unit and the emergency department. There were 315 reported episodes of occupational exposure among 306 HCWs. Nurses (34.0%) were the HCWs most frequently exposed and percutaneous injury (91.4%) was the most common type of exposure. One-third of the source patients tested were infected with HIV. PEP was initiated following 200 (63.5%) of the 315 exposures and was started within 24h in >95% of cases. The most commonly prescribed PEP regimen was zidovudine, lamivudine and nelfinavir. Fifty-six percent of HCWs given PEP completed a four-week course but the remainder discontinued PEP prematurely due to side-effects, or after negative results from the source, or following informed risk reassessment or from their own accord. No exposed HCW acquired HIV during the study period. Appropriate counselling and careful risk assessment are important in achieving effective HIV PEP among HCWs.
这是一项对泰国曼谷朱拉隆功国王纪念医院（KCMH）医护人员职业暴露于人类免疫缺陷病毒（HIV）及后续暴露后预防（PEP）情况的回顾性研究。2002年1月至2004年12月期间，从事件报告、医院传染病科和急诊科收集数据。306名医护人员中有315起职业暴露报告事件。护士（34.0%）是暴露最频繁的医护人员，经皮损伤（91.4%）是最常见的暴露类型。三分之一的受检源患者感染了HIV。315起暴露事件中有200起（63.5%）启动了PEP，超过95%的病例在24小时内开始用药。最常用的PEP方案是齐多夫定、拉米夫定和奈非那韦。接受PEP的医护人员中有56%完成了为期四周的疗程，但其余人员因副作用、源患者检测结果为阴性、经过知情风险重新评估或自行决定而提前停止了PEP。在研究期间，没有暴露的医护人员感染HIV。适当的咨询和仔细的风险评估对于医护人员实现有效的HIV暴露后预防至关重要。
