Siika Abraham M, Nyandiko Winston M, Mwangi Ann, Waxman Michael, Sidle John E, Kimaiyo Sylvester N, Wools-Kaloustian Kara
Department of Medicine, Moi University School of Medicine, Eldoret, Kenya.
J Acquir Immune Defic Syndr. 2009 May 1;51(1):47-53. doi: 10.1097/QAI.0b013e318198a96a.
In 2001, HIV postexposure prophylaxis (PEP) was initiated in western Kenya.
Design, implementation, and evolution of the PEP program are described. Patient data were analyzed for reasons, time to initiation, and PEP outcome.
Occupational PEP was initiated first followed by nonoccupational PEP (nPEP). Antiretroviral regimens were based upon national PEP guidelines, affordability and availability, and prevailing HIV prevalence. Emerging side effects data and cost improvements influenced regimen changes. Between November 2001 and December 2006, 446 patients sought PEP. Occupational exposure: 91 patients: 51 males; 72 accepted HIV testing; 48 of 52 source patients were HIV infected; median exposure-PEP time 3 hours (range: 0.3-96 hours). Of 72 HIV-negative patients receiving PEP, 3 discontinued, 69 completed, and 23 performed post-PEP HIV RNA polymerase chain reaction (all negative). Eleven follow-up HIV enzyme-linked immunosorbent assay tests have all turned negative. Nonoccupational exposure: 355 patients; 285 females; 90 children; 300 accepted HIV testing; median exposure-nPEP time 19 hours (range: 1-672 hours). Of 296 HIV-negative patients on nPEP, 1 died, 15 discontinued, 104 are on record having completed PEP, and 129 returned for 6-week HIV RNA polymerase chain reaction (1 patient tested positive). Eighty-seven follow-up HIV enzyme-linked immunosorbent assay tests have all turned negative.
It is feasible to provide PEP and nPEP in resource-constrained settings.
2001年，肯尼亚西部开始实施HIV暴露后预防（PEP）。
描述了PEP项目的设计、实施及演变过程。分析了患者数据的原因、开始时间及PEP结果。
职业性PEP最先启动，随后是非职业性PEP（nPEP）。抗逆转录病毒治疗方案基于国家PEP指南、可负担性和可获得性以及当地流行的HIV患病率。新出现的副作用数据和成本改善影响了治疗方案的改变。2001年11月至2006年12月期间，446名患者寻求PEP。职业暴露：91名患者，其中男性51名；72名接受了HIV检测；52名源患者中有48名HIV感染；暴露至PEP的中位时间为3小时（范围：0.3 - 96小时）。72名接受PEP的HIV阴性患者中，3名停药，69名完成治疗，23名进行了PEP后HIV RNA聚合酶链反应（均为阴性）。11次随访HIV酶联免疫吸附试验结果均为阴性。非职业暴露：355名患者，其中女性285名，儿童90名；300名接受了HIV检测；暴露至nPEP的中位时间为19小时（范围：1 - 672小时）。296名接受nPEP的HIV阴性患者中，1名死亡，15名停药，104名记录显示已完成PEP，129名返回进行6周HIV RNA聚合酶链反应（1名患者检测呈阳性）。87次随访HIV酶联免疫吸附试验结果均为阴性。
在资源有限的环境中提供PEP和nPEP是可行的。
