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Danish post-exposure prophylaxis (PEP) registry: 10 years experience with the use of PEP following HIV exposure
Presented by Suzanne Lunding, Denmark.
Lunding S.1, Katzenstein T.L.2, Kronborg G.3, Lindberg J.4, Jensen J.5, Nielsen H.I.6, Pedersen C.7, Kristensen L.8
1Helsingor Hospital, Department of Infectious Diseases, Helsingor, Denmark, 2Rigshospitalet, Department of Infectious Diseases, Copenhagen, Denmark, 3Hvidovre Hospital, Department of Infectious Diseases, Hvidovre, Denmark, 4Skejby Hospital, Department of Infectious Diseases, Aarhus, Denmark, 5Kolding Hospital, Department of Infectious Diseases, Kolding, Denmark, 6Aalborg Hospital, Department of Infectious Diseases, Aalborg, Denmark, 7Odense Hospital, Department of Infectious Diseases, Odense, Denmark, 8Viborg Hospital, Department of Internal Medicine, Viborg, Denmark
Objectives: To describe the use of PEP in Denmark since the first case in 1997.
Methods: All clinics in Denmark prescribing PEP reported retrospective data on all PEP cases to the Danish PEP registry. Data from 1998 (sexual exposure)and 1999 (occupational and other blood exposure) up to sept. 2006 is presented. Data on the frequency of PEP for occupational exposures in 1997-1998 is derived from a seperate study*.
Results: PEP was given to 357 patients following sexual exposure.The incidense from 1998-2006 was 5, 12, 38, 47, 43, 54, 58, 59 and 72** cases/year.78% were men, 58% were homosexual. Most frequent indication for PEP was receptive anal intercourse 41%, insertive anal intercourse 15%, receptive vaginal intercourse 20% and insertive vaginal intercourse 17%. In 29 cases (8%) the patient had been raped.In 146 cases (41%) the HIV-status of the source was unknown - of these 64% was initiated due to receptive anal intercourse. PEP was prescribed more than once to 22 patients, in 2006 alone 8 patients had PEP previously. The incidence of PEP following occupational exposure from 1997-2006 was 12,35,23,24,27,39,32,34,43 and 20** cases/year. Data from 1999-2006 (N=242) is presented. 80% had percutaneous exposures.29% were nurses, 22% doctors and 7% dentists. In 35% the HIV-status of the source was unknown - 64% of these were tested and 76% belonged to high-risk groups. Median time to PEP initiation was 10,4 hours (0,5-60) after sexual exposure and 2,0 hours (0,15-37) after occupational exposures. Of the total 599 cases, 59% completed PEP,9% stopped because the source tested negative and 5 % stopped due to adverse effects.
Conclusions: In Denmark PEP can only be prescribed by specialists in infectious diseases which ensures a qualified risk assesment. Although PEP following sexual exposure PEP is increasing, repeated administration of PEP is rare.
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