Jaundice with unconjugated bilirubin after prophylactic anti-retroviral therapy in a case of sexual aggression

BACKGROUND: interest has recently focused on anti-HIV prophylaxis in case o f sexual exposure. A circular from the French Ministry of Health (DCS/DH n degrees 97/560, 12 August 1997) envisages such treatment in certain risk si tuations such as sexual aggression. The toxic risk of prescribing a trither apy or a bitherapy, even for a short period of a few weeks must be consider ed. CASE REPORT: A 20-year-old rape victim with an uneventful medical history w as given a prophylactic regimen including zidovudine, laminovudine and indi navir. Three months later, she developed free-bilirubin jaundice with biolo gical signs of hemolysis. DISCUSSION: We draw attention to the risk of severe adverse effects of shor t-duration anti-HIV prophylaxis in apparently healthy subjects. The protoco l must included careful patient information and rigorous surveillance.