Medicina interna, Hospital Universitario Fundación Jiménez Díaz, Madrid, Madrid, Spain.
Hospital Universitario Fundacion Jimenez Diaz, Madrid, Madrid, Spain.
Sex Transm Infect. 2024 May 31;100(4):231-235. doi: 10.1136/sextrans-2024-056109.
INTRODUCTION/OBJECTIVES: The use of non-occupational post-exposure prophylaxis (nPEP) emerges as a strategic intervention to reduce HIV infection risk following sexual encounters in our setting. Notwithstanding, there is a scarcity of contemporary data regarding adherence to this treatment, its effectiveness and tolerance. Our study aims to delve into these factors among individuals who have resorted to nPEP after high-risk sexual encounters.
We conducted a retrospective observational study of cases administered nPEP for HIV from 1 January 2018 to 31 December 2021 at a tertiary hospital in Madrid. The study included all adults over 18 years who sought care at the emergency department of the Fundación Jiménez Díaz Hospital following a risky sexual encounter and were subsequently recommended HIV nPEP treatment.
878 individuals received nPEP for HIV and underwent initial serological tests. Of these, 621 had comprehensive follow-ups. The prescribed regimen for all was raltegravir (RAL) 1200 mg combined with tenofovir/emtricitabine (TDF/FTC) 245/200 mg daily for 28 days. The study revealed a 1.1% rate (n=10) of previously undetected infection and a 0.16% (n=1) failure rate of nPEP. Regarding regimen tolerability, 5.6% (n=35) experienced symptoms linked to the treatment, yet none necessitated discontinuation of the regimen. On the contrary, six per cent (n=53) reported symptoms consistent with an STI during one of the medical visits; specifically, 4.4% had urethritis, and 1.6% had proctitis.
nPEP with RAL/TDF/FTC demonstrates high efficacy and safety, contingent on proper adherence. There is an observed increase in STI prevalence in this cohort, with nearly half of the participants not engaging in appropriate follow-up after initiating nPEP.
简介/目的：在我们的环境中，非职业性接触后预防（nPEP）的使用作为一种降低性接触后 HIV 感染风险的策略性干预措施而出现。尽管如此，关于这种治疗的依从性、效果和耐受性，我们目前的数据仍然有限。我们的研究旨在深入了解在高风险性行为后使用 nPEP 的个体的这些因素。
我们对 2018 年 1 月 1 日至 2021 年 12 月 31 日期间在马德里的一家三级医院接受 nPEP 治疗的 HIV 感染者进行了回顾性观察性研究。该研究包括所有 18 岁以上在发生高危性行为后前往 Fundación Jiménez Díaz 医院急诊科就诊并随后被推荐接受 HIV nPEP 治疗的成年人。
878 名个体接受了 HIV nPEP 治疗并进行了初始血清学检测。其中，621 名个体接受了全面随访。所有个体均接受了拉替拉韦（RAL）1200mg 联合替诺福韦/恩曲他滨（TDF/FTC）245/200mg 每日一次的方案治疗，持续 28 天。研究显示，1.1%（n=10）的个体存在先前未检出的感染，nPEP 失败率为 0.16%（n=1）。关于方案的耐受性，5.6%（n=35）出现了与治疗相关的症状，但没有个体因此停止治疗方案。相反，6%（n=53）的个体在某次就诊时报告了与性传播感染一致的症状；具体而言，4.4%的个体患有尿道炎，1.6%的个体患有直肠炎。
RAL/TDF/FTC 的 nPEP 具有较高的疗效和安全性，但需要正确的依从性。在该队列中观察到性传播感染的患病率增加，近一半的个体在开始 nPEP 后未进行适当的随访。
