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尼日利亚一家三级医疗机构中HIV非职业性暴露后预防用药情况评估

Evaluation of HIV Non-occupational Post-exposure Prophylaxis Utilisation in a Tertiary Health Facility in Nigeria.

作者信息

Olanrewaju Fatai Olatunde, Oripelaye Muphy Mufutau, Ajani Atinuke Arinola, Enitan Ademola Olusegun

机构信息

Department of Dermatology/Venereology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.

Department of Dermatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.

出版信息

Rwanda J Med Health Sci. 2022 Dec 20;5(3):264-275. doi: 10.4314/rjmhs.v5i3.2. eCollection 2022 Dec.

Abstract

BACKGROUND

The Sub-Saharan Africa accounts for more than 70% of the global burden of HIV infections. Non-occupational post-exposure prophylaxis, when initiated within 72 hours of HIV exposure for 28 days, can prevent seroconversion in 80% of HIV exposures.

OBJECTIVES

To evaluate the characteristics, prevalence and outcome of non-occupational HIV post-exposure prophylaxis utilization in a tertiary hospital.

METHOD

This was a retrospective study that involved the medical records of 143 patients who sought HIV non-occupational post-exposure prophylaxis between 1st June 2011 and 31st May 2021. A questionnaire was used to collect information about the socio-demographic data, profiles of both the source and exposed persons, antiretroviral completion rate and outcome at follow-up.

RESULTS

Females accounted for 125 (87.4%). Sexual assaults were the main reasons for seeking non-occupational post-exposure prophylaxis in 119 (83.2%). High-risk exposures were observed in 134 (93.7%). HIV status of the sources was unknown in 126 (88.1%). 123 (86.0%) initiated antiretroviral within 72 hours of exposure and antiretroviral completion rate was 70.6%. Only 28 (19.6%) reported for follow-up scheduled HIV screening and were all negative.

CONCLUSION

Early initiation of postexposure prophylaxis, improvement in baseline HIV testing of the source, and follow-up HIV screening, will significantly improve services and outcomes.

摘要

背景

撒哈拉以南非洲地区承担了全球70%以上的艾滋病毒感染负担。非职业性暴露后预防措施若在艾滋病毒暴露后72小时内开始并持续28天,可使80%的艾滋病毒暴露者预防血清转化。

目的

评估一家三级医院中非职业性艾滋病毒暴露后预防措施的使用特征、患病率及结果。

方法

这是一项回顾性研究,涉及2011年6月1日至2021年5月31日期间寻求非职业性艾滋病毒暴露后预防措施的143例患者的病历。采用问卷调查收集社会人口统计学数据、源接触者和暴露者的资料、抗逆转录病毒药物完成率及随访结果等信息。

结果

女性占125例(87.4%)。性侵犯是119例(83.2%)寻求非职业性暴露后预防措施的主要原因。134例(93.7%)存在高风险暴露。126例(88.1%)源接触者的艾滋病毒感染状况未知。123例(86.0%)在暴露后72小时内开始使用抗逆转录病毒药物,抗逆转录病毒药物完成率为70.6%。只有28例(19.6%)按计划进行了随访艾滋病毒筛查,结果均为阴性。

结论

尽早开始暴露后预防、改善源接触者的基线艾滋病毒检测以及进行随访艾滋病毒筛查,将显著改善服务和结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2123/12240428/3117eb5f53b0/RJMHS0503-0264Fig1.jpg

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