Patterns of Occupational Exposure to Human Immunodeficiency Virus and Post-Exposure Prophylaxis Among Health Care Personnel in a Tertiary Care Institute in South India - A Retrospective Case Series.

Abstract

Post-exposure prophylaxis (PEP) for occupational human immunodeficiency virus (HIV) exposure involves the comprehensive measures used to prevent transmission of blood-borne pathogens such as HIV, hepatitis B virus, and hepatitis C virus through various strategies such as first aid, counseling, risk assessment, relevant laboratory investigations with informed consent, the provision of short-term anti-retroviral drugs, and follow-up testing. We sought to investigate the patterns and causes of occupational exposure in health care workers (HCWs) in our institute and the usage of PEP in our center, a tertiary care hospital in south India. The study involved a retrospective analysis of data extracted from the records of PEP usage from the anti-retroviral treatment (ART) center attached to the dermatology, venereology and leprosy out-patient department of a tertiary care center in south India. The data were extracted into a pre-designed proforma and analyzed using descriptive statistics. A total of 352 health care professionals reported to the ART center for PEP from 2010 to 2020. One hundred and thirty-four patients took only the first dose as the source patient later tested to be HIV-negative. Among the 218 remaining patients, 84 were male and 134 were female patients. Only 56 health care workers started the regimen within 2 hours. One hundred and thirty-four patients completed the full course of PEP. Most HCWs (n = 68, 31%) sustained the exposure while doing a procedure on the patient followed by re-capping a needle (n = 64, 29%). Gastritis and drowsiness were the most common adverse effects. The study was limited by the retrospective nature of data collection and the lack of detailed interviews with HCWs. Knowledge about PEP, needle safety training, and training of early first aid measures should be increased among health care workers.