Post exposure prophylaxis for HIV among healthcare workers due to occupational exposure: a record based study at a tertiary care teaching hospital of Kolkata

Abstract

Background: Healthcare workers (HCWs) regularly face the risk of exposure to sharp injuries and splashes as an occupational hazard, which presents major risk for acquiring blood-borne infectious agents like human immunodeficiency virus (HIV) which can be minimized by taking post exposure prophylaxis (PEP) measures. There are limited studies from India documenting details of PEP for HIV. This record-based study aimed to determine the occurrence of needle stick injuries (NSIs) and other high-risk occupational exposures to blood and body fluids (BBFs) among HCWs in a tertiary care hospital, Kolkata. We aimed to study details of PEP regimens used among HCWs exposed to HIV.Methods: Hospital record was analyzed from reported incidences of occupational exposures to BBFs occurred during the period of October 2013 to March 2019. Information on self-reported incidence of occupational exposure, and post-exposure management were collected.Results: A total of 105 incidents of occupational exposure were registered during study period. Interns (37, 35.2%) were most frequently exposed, followed by physicians (22, 21.0%) and nurse (21, 20.0%). 88 (83.8%) of the personnel sustained NSIs, and 17 (7.2%) had splashes to skin, mucus membranes. There was no significant difference between subjects with splashes to skin, mucus membranes and needle-stick cases regarding discontinuation of post exposure prophylaxis (PEP) (11.8% versus 19.3%, p<0.548). No cases of sero-conversion were reported.Conclusions: In spite of high incidences of exposures to HIV source, good efficacy of PEP was observed with no sero-conversion. PEP for HIV was well tolerated. Study emphasized the need for creating awareness about timely reporting of incidence.