Pierce Anna B, Yohannes Keflemariam, Guy Rebecca, Watson Kerrie M, Armishaw Jude, Price Brian, Hoy Jennifer F, Wright Edwina J, Stoové Mark A
Victorian NPEP Service, Infectious Diseases Unit, The Alfred Hospital, Melbourne, Vic. 3004, Australia.
Sex Health. 2011 Jun;8(2):179-83. doi: 10.1071/SH10063.
Despite widespread prescription of non-occupational post-exposure prophylaxis (NPEP) in Victoria, little is known about subsequent HIV acquisition among NPEP users. We linked the Victorian NPEP Service (VNPEPS) database and the Victorian HIV Surveillance Registry to determine the number, incidence rate and predictive factors of HIV seroconversions among users of the VNPEPS.
Records from male patients that received NPEP in the VNPEPS database (n = 1420) between January 2001 and February 2008 were linked with all entries in the Victorian HIV Surveillance Registry up to May 2008.
Sixty-one men who presented to the VNPEPS were identified as HIV seropositive; 16 of these were diagnosed at initial presentation for NPEP. The incidence of HIV seroconversion in males who were HIV seronegative at first presentation for NPEP was 1.27 (95% confidence interval 0.95-1.70) per 100 person-years. There was no association between HIV seroconversion and number of NPEP presentations or age. The median age of seroconversion was 34.6 years.
The incidence of HIV infection among men presenting to the VNPEPS is slightly lower than the HIV incidence in NPEP users in a recent Australian cohort study of men who have sex with men, but higher than HIV incidence in general gay male populations. Frequency of NPEP use was not associated with risk of HIV seroconversion. Examination of risk behaviour before and after NPEP use in this population is required to further assess the impact of NPEP availability and use on HIV incidence rates and risk behaviour in Australia.
尽管维多利亚州广泛开具非职业性暴露后预防（NPEP）处方，但对于NPEP使用者后续感染艾滋病毒的情况知之甚少。我们将维多利亚州NPEP服务（VNPEPS）数据库与维多利亚州艾滋病毒监测登记处相链接，以确定VNPEPS使用者中艾滋病毒血清转化的数量、发病率及预测因素。
2001年1月至2008年2月期间在VNPEPS数据库中接受NPEP的男性患者记录（n = 1420）与截至2008年5月维多利亚州艾滋病毒监测登记处的所有记录相链接。
61名前往VNPEPS的男性被确定为艾滋病毒血清学阳性；其中16人在初次接受NPEP时被诊断出感染。初次接受NPEP时艾滋病毒血清学阴性的男性中，艾滋病毒血清转化的发病率为每100人年1.27例（95%置信区间0.95 - 1.70）。艾滋病毒血清转化与NPEP就诊次数或年龄之间无关联。血清转化的中位年龄为34.6岁。
前往VNPEPS的男性中艾滋病毒感染率略低于澳大利亚近期一项针对男男性行为者的队列研究中NPEP使用者的艾滋病毒感染率，但高于一般男同性恋人群中的艾滋病毒感染率。NPEP使用频率与艾滋病毒血清转化风险无关。需要对该人群使用NPEP前后的风险行为进行检查，以进一步评估NPEP的可及性和使用对澳大利亚艾滋病毒发病率及风险行为的影响。
