Occupational exposure, drug toxicities and adherence to HIV post exposure prophylaxis: a cohort study at the teaching hospital in Erode district, Tamilnadu, India

Authors

  • Mohankumar Vedhanayagam Associate Professor, Department of Skin and STDs, IRT Perundurai Medical College Hospital, Perundurai, Erode, Tamilnadu 638053, India
  • Senthilkumar Sengodan Professor, Department of Skin and STDs, IRT Perundurai Medical College Hospital, Perundurai, Erode, Tamilnadu 638053, India
  • Rajesh Rajagopalan Professor & HOD, Department of Surgery, IRT Perundurai Medical College Hospital, Perundurai, Erode, Tamilnadu 638053, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20162507

Keywords:

Human immunodeficiency virus, Health care personnel, Occupational exposure, Post-exposure

Abstract

Background: Human immunodeficiency virus (HIV) infection to healthcare personals follows occupational exposure follows accidental needle stick injuries can be minimized less than <1% with post-exposure prophylaxis with antiretroviral drugs in time. Retrospective review of records of occupational exposure to HIV, analyse post exposure prophylaxis drug side effects and adherence.

Methods: On-going documentation of occupational exposures with known source of infection (HIV reactive) reported at IRT Perundurai Medical College Hospital, Erode district, Tamilnadu, India from January 2008 to March 2016 were reviewed.

Results: A total of 14 cases (4 males and 10 females) occupational exposure to HIV infections were documented. 9 interns, 13 needle stick injuries, 7 needle recapping, 8 mild exposure, 10 washing  with water or soap and water, 11 with less than one year of practical  experience,   10 completed the follow up were the common subdivisions. ZL for 12 and TLE for 2 were prescribed. Nausea and vomiting were the commonest and bothersome side effect. One intern stopped PEP after 4 days because of extensive nausea, vomiting and fatigue but all others completed PEP.

Conclusions: HCPs need to be given in-service training and mentoring regarding universal work precautions, management of occupational exposure, PEP, adverse events and management, and continued active follow‑up to ensure the adherence by mobile and social media. This is very helpful in curtailing the risk of occupational HIV sero-conversion.

References

Antiretroviral Therapy Guidelines for HIV-Infected Adults and Adolescents Including Post-exposure Prophylaxis, May 2007, NACO, Ministry of Health & Family Welfare, Government of India

ART guidelines for HIV-Infected Adults and Adolescents: May 2013, NACO, Ministry of Health & Family Welfare, Government of India

Kuhar DT, Henderson DK, Struble KA, Heneine W, Thomas V, Cheever LW, et al; US PHS Guidelines for the Management of Occupational Exposures to HIV; Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Post exposure Prophylaxis. Infect Control Hosp Epidemiol. 2013;34(9):875-92.

Chronic HIV Care with ARV Therapy and Prevention; Integrated Management of Adolescent and Adult Illness; Interim Guidelines for health workers at Health Centre or Clinic at District Hospital Outpatient; April 2006; WHO.

Post-exposure prophylaxis for HIV; Supplementary section to the 2013 WHO consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection; WHO. 2013;15-26.

Goldschmidt; Perspective Occupational Postexposure Prophylaxis for HIV: The PEPline Perspective; Topics HIV Medicine, International AIDS Society–USA. 2010;18(5):174-7.

Marcus R, Kay K, Mann JM. Transmission of human immunodeficiency virus (HIV) in health-care settings worldwide; Bulletin of the World Health Organization. 1989;67(5):577-82.

Sultan B, Benn P, Waters L. Current perspectives in HIV post-exposure prophylaxis; HIV/AIDS–Research and Palliative Care. HIV AIDS (Auckl). 2014;6:147-58.

Sharma A, Marfatia YS, Ghiya R. Post-exposure prophylaxis for HIV. Indian J Sex Transm Dis. 2007;28:61-8.

Tettehr RA, Nartey ET, Lartey M, Mantel-Teeuwisse AK, Leufkens HGM, Nortey PA, et al. Adverse events and adherence to HIV post-exposure prophylaxis: a cohort study at the Korle-Bu Teaching Hospital in Accra, Ghana. BMC Public Health 2015;15:573.

Varghese GM, Abraham OC, Mathai D. Post-exposure prophylaxis for blood borne viral infections in healthcare workers; Postgrad Med J 2003;79:324-8.

Gupta A, Anand S, Sastry J, Krisagar A, Basavaraj A, Bhat SM, et al. High risk for occupational exposure to HIV and utilization of post-exposure prophylaxis in a teaching hospital in Pune, India; BMC Infectious Diseases 2008;8:142.

Merchant RC, Chee KJ, Tao Liu, Mayer KH. Incidence of Visits for Health Care Worker Blood or Body Fluid Exposures and HIV Postexposure Prophylaxis Provision at Rhode Island Emergency Departments; J Acquir Immune Defic Syndr. 2008;47(3):358-68.

Jeremy JE. Johnston and Emily O’Conor; Needlestick injuries, management and education: a role for emergency medicine?; European Journal of Emergency Medicine. 2005;12:10-2.

Nwankwo TO, Aniebue UU. Percutaneous injuries and accidental blood exposure in surgical residents: Awareness and use of prophylaxis in relation to HIV; Nigerian Journal of Clinical Practice. 2011;14(1):34-7.

Shriyan A, Annamma RR. Incidence of occupational exposures in a tertiary health care center. Indian J Sex Transm Dis. 2012;33:91-7.

Aggarwal V, Seth A, Chandra J, Gupta R, Kumar P, Dutta AK. Occupational exposure to human immunodeficiency virus in health care providers: A retrospective analysis. Indian J Community Med. 2012;37:45-9.

Jelle AE, Hafsteinsdottir EJ, Gudlaugsson O, Kristjansson M. Epidemiology of needlesticks at Landspítali University Hospital during the years 1986- 2011. A descriptive study. Occupational needlestick injuries in hospitals. Laeknabladid. 2013;99(12):55964.

Chen MY, Fox EF, Rogers CA. Post-exposure prophylaxis for human immunodeficiency virus: knowledge and experience of junior doctors; Short report; Sex Transm Inf. 2001;77:444-5.

Mukherjee S, Bhattacharyya A, Sarkar BS, Goswami DN, Ghosh S, Samanta A. Knowledge and Practice of Standard Precautions and Awareness Regarding Post-Exposure Prophylaxis for HIV among Interns of a Medical College in West Bengal, India; Brief Communication; Oman Medical Journal. 2013;28(2):141-5.

Chaudhuri S, Baidya OP, SinghTG. Universal precaution: practice among doctors in a tertiary care hospital in Manipur. Int J Res Med Sci. 2016;4:606-9.

Powers D, Armellino D, Dolansky M, Fitzpatrick J. Factors influencing nurse compliance with Standard Precautions. Am J Infect Control. 2016;44(1):4-7.

Falagas ME, Karydis I, Kostogiannou I. Percutaneous Exposure Incidents of the Health Care Personnel in a Newly Founded Tertiary Hospital: A Prospective Study. PLoS ONE. 2007;2(2):e194.

Mohammadi N, Allami A, Malek Mohamadi R. Percutaneous exposure incidents in nurses: Knowledge, practice and exposure to hepatitis B. Hepat Mon. 2011;11(3):186-90.

Miceli M, Herrera F. Adherence to an Occupational Blood Borne Pathogens Exposure Management Program Among Healthcare Workers and Other Groups at Risk in Argentina; The Brazilian Journal of Infectious Diseases. 2005;9(6):454-8.

Shevkani M, Kavina B, Kumar P, Purohit H, Nihalani U, Shah A. An overview of post exposure prophylaxis for HIV in health care personals:Gujarat scenario. Indian J Sex Transm Dis. 2011;32:9-13.

Baggaley R, Doherty M, Ball A, Ford N, Hirnschall G. The Strategic Use of Antiretrovirals to Prevent HIV Infection: A Converging Agenda; Clinical Infectious Diseases. 2015;60(S3):S159-60.

Marcus R, Kay K, Mann JM. Transmission of human immunodeficiency virus (HIV) in health-care settings worldwide; Bulletin of the World Health Organization. 1989;67 (5):577-82.

Ford N, Irvine C, Shubber Z, Baggaley R, Beanland R, Vitoria M, et al; WHO, Adherence to HIV postexposure prophylaxis: a systematic review and metaanalysis; AIDS. 2014;28(18):2721-7.

Downloads

Published

2016-12-29

Issue

Section

Original Research Articles