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Characteristics and rates of infection by HIV in people receiving non-occupational post-exposure prophylaxis (nPEP) against HIV
  1. Irene Carrillo1,
  2. Marta López de las Heras2,
  3. Silvia Calpena Martínez2,
  4. Laura Prieto-Pérez2,3,
  5. Beatriz Álvarez Álvarez2,3,
  6. Aws Waleed Al-Hayani2,
  7. José Izuzquiza Suarez-Inclan2,
  8. Sara Lumbreras Fernandez2,
  9. Patricia Quesada Luengo2,
  10. María Elia Asensi Diaz2,
  11. Marina Bernal Palacios2,
  12. Paula Asensio Mathews2,
  13. Barbara Soler Bonafont2,
  14. Raquel Bravo Ruiz2,
  15. Marta Hernández-Segurado4,
  16. Miguel Górgolas2,3,
  17. Alfonso Cabello5
  1. 1Medicina interna, Hospital Universitario Fundación Jiménez Díaz, Madrid, Madrid, Spain
  2. 2Hospital Universitario Fundacion Jimenez Diaz, Madrid, Madrid, Spain
  3. 3Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
  4. 4Department of Pharmacy, Hospital Universitario Fundacion Jimenez Diaz, Madrid, Madrid, Spain
  5. 5Division of Infectious Diseases, Fundación Jiménez Díaz, Madrid, Madrid, Spain
  1. Correspondence to Alfonso Cabello, Division of Infectious Diseases, Fundación Jiménez Díaz, Madrid 28040, Madrid, Spain; alcubeda{at}yahoo.es

Abstract

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.

Methods 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.

Results 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.

Conclusion 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.

  • HIV
  • Post-Exposure Prophylaxis
  • AIDS
  • Pre-Exposure Prophylaxis

Data availability statement

No data are available.

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Data availability statement

No data are available.

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Footnotes

  • Handling editor Mark Charles Atkins

  • IC, MG and AC conceived the study, participated in its design, data analysis and drafted the manuscript. MLdlH, SCM, LP-P, BAA, AWA-H, JIS-I, SLF, PQL, MEAD, MBP, PAM, BSB, RBR and MH-S were responsible for managing the database and have participated in its design and drafted the manuscript. All the authors contributed to the final version of the manuscript.

    The responsible authors for the overall content as guarantors are ICA, ACU, and MG.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.