Postexposure prophylaxis against the human immunodeficiency virus among health care workers involved in incidents with biological material
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2024.213236Keywords:
HIV infections, Occupational exposure, Health care workers, Postexposure prophylaxisAbstract
Introduction: Postexposure prophylaxis (PEP) reduces the risk of human immunodeficiency
virus (HIV) transmission after workplace exposure of health care workers. Objectives: To
evaluate adherence to postexposure prophylaxis for HIV, incident characteristics, post-incident
initiation of therapy, and reported adverse effects among treated health care workers. Methods: Epidemiologic, descriptive, retrospective study based on analysis of workplace incident reports involving exposure to biological materials from 2011 to 2020 at a university hospital. Data were analyzed using descriptive statistics, odds ratio using simple logistic regression, and comparison of variables using Fisher’s exact test (p<0.05). Results: A total of 516 cases eligible for prophylaxis were analyzed and divided into three risk groups: 168 (32.6%) involving HIV-positive source patients, 263 (50.9%) involving source patients with unknown infection status, and 85 (16.4%) involving source patients in the window period. Most cases involved females (74.80%), injuries from percutaneous exposure (80.42%), contact with blood (56.59%), and nursing technicians (30.46%). Full compliance and adherence with drug therapy (28 days) was reported in 77.45% of the workers, and the time between the incident and the start of prophylaxis was within 24 hours of the incident in 94.27% of the workers. In total, 205 (39.73%) of the workers discontinued outpatient follow-up, which was associated with education, risk group, and occupation. Conclusions: Incidents involving contaminated sharp instruments pose an increased risk of infection by pathogens transmitted primarily by blood. Workplace HIV infection can be prevented by providing mandatory training programs for workers on proper work practices, use of devices with retractable needles and needle protection systems, safe and proper disposal of materials,
use of personal protective equipment, and appropriate workplace postexposure interventions, including PEP. None of the workers who completed outpatient follow-up seroconverted to HIV, thus demonstrating the protective effect of PEP. Regular training is recommended, with an emphasis on incident prevention, infection control, and health education, combined with case reporting strategies.
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Copyright (c) 2024 Fernanda Sucasas Frison, Herling Gregório Aguilar Alonzo, Maria Helena Pavan, Inajara de Cássia Guerreiro
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