Pan-Thames survey of occupational exposure to HIV and the use of post-exposure prophylaxis in 71 NHS Trusts

Objectives: To review the management of occupational exposure to definite o r suspected HIV-infected blood, following the introduction of the 1997 UK D epartment of Wealth guidelines on the use of post-exposure prophylaxis. Methods: Cross-sectional telephone survey of protocols in 71 NHS Trusts in the Pan-Thames region. Retrospective postal survey of the management of eac h definite or suspected HIV blood exposure between 1 July 1997 and 30 June 1999. Results: Sixty-two (93%) Trusts had a written protocol, with many specialti es involved in exposure management. Twenty-four Trusts reported 171 occupat ional exposures to definite or suspected HIV-infected blood. Of 97 definite HIV exposures, eight (8%) were discovered on post-incident HIV testing of the source patient; to which most source patients agreed when approached, S eventy-two (74%) exposed health care workers started prophylaxis and 49 (68 %) completed the recommended 4-week course. Only half of those whose exposu res occurred more than 6 months ago were known to have had a follow-up HIV test. Conclusions: Although most Trusts have implemented the Department of Health 's guidance, collecting data on individual exposures proved difficult. We s uggest that a designated department in each Trust co-ordinates and records HIV exposure management. Routine HIV testing is acceptable to most source p atients and is appropriate in areas with a high prevalence of HIV seroposit ivity. (C) 2001 The British Infection Society.