Servey of HIV Exposure and Postexposure Prophylaxis among Health Care Workers in Korea / 병원감염관리

ABSTRACT

BACKGROUND: As of 30 September 2001, a total of 1,515 human immunodeficiency virus(HIV) infected persons has been reported in Korea. The number of newly infected persons tends to increase year by year, with the result that the contacts between HIV infected persons and health care workers (HCW) become more frequent. This survey was to investigate the current state of occupational HIV exposure and postexposure management among HCW in Korea. METHODS: We surveyed retrospectively the cases of occupational HIV exposure reported until the first half of 2001, in total 14 tertiary teaching hospitals. We reviewed these cases for the details about ; i) exposure type. medium and depth of injuty, ii) postexposure prophylaxis(PEP) and follow up serologic test and iii) source patients. RESULTS: Forty-eight cases(65% female, no pregnant woman) of occupational HIV exposure were identified. The number of cases tends to increase rapidly in recent two years. The majority of the exposure occurred in nurses and doctors, after percutaneous needle stick injury. The mean time from exposure to administration of PEP drugs was 20 hours. Of 39 cases receiving the PEP drug, 62% completed all of the drugs as initially prescribed and 31% discontinued all PEP drugs. The reasons for discontinuation included adverse events(9 cases), health care provider judgment(1case), and source patient HIV negative(1case). There was at least one adverse event in 59% of cases receiving the PEP drugs. The most frequent adverse events were gastrointestinal symptoms such as nausea. vomiting, anorexia, and indigestion. So far. there has been no HCW infected with HIV via occupational exposure. Conelusion: Although primary prevention remains the best strategy for protecting HCW from occupational HIV transmission, exposures are nevertheless likely to occur. Systematized PEP programs that include written protocols for prompt reporting, evaluation, counseling, treatment. and follow-up of occupational exposures will be needed for the secondary prevention.