TOLERANCE, COMPLIANCE AND PSYCHOLOGICAL CONSEQUENCES OF POSTEXPOSURE PROPHYLAXIS IN HEALTH-CARE WORKERS

Our objectives were to evaluate tolerance and compliance of postexposu re triple therapy in health-care workers (HCWs) by retrospective obser vational study. Structured telephone interview of HCWs identified thro ugh data from antiretroviral prescribing centres. Twenty HCWs who rece ived triple prophylaxis were identified over one year. Sixteen agreed to participate in the study. All but one source patient had documented HIV infection. Half HCWs were not aware of post-exposure therapy. Mos t HCWs received a zidovudine, lamivudine and indinavir combination. Al l completed at least 4 weeks of therapy. Only 50% received their first dosage less than 4h after exposure. Nearly all experienced adverse ev ents, mostly digestive (nausea and abdominal pain n=15) or psychologic al (anxiety and depression n=15), none resulting in therapy discontinu ation. Most events occurred 2 to 7 days after therapy initiation. Most modified their sexual life with abstinence or condom use. Compliance was excellent. Half HCWs did not miss any tablet, 4 forgot one dosing a month and 4 one dosing a week. Follow up is over 6 months in all but one HCW. No HIV seroconversion has been observed to date. In France, post-exposure triple antiretroviral therapy is widely available 24 h a day in every emergency room but further training and development of H CWs is needed to decrease consulting time and increase referral to spe cialized physicians. Notable moderate adverse events, both physical an d psychological are noted, however, compliance is excellent.