Prophylaxis regimens after HIV occupational exposure: review of literature

Abstract

Despite being responsible for a small number of seroconversion, occupational accidents related to biological materials infected with HIV still cause great impact on the injured worker. Since the beginning of AIDS epidemic, a major concern has been shown to prevent the infection in workplaces. Thus, this study aims to review

the literature about prophylaxis regimens after the HIV occupational exposure and the current recommendations given to doctors regarding procedures in occupational accidents with a potentially HIV-contaminated biological material, comparing the difference between them in several countries. This review notices that, initially, it was given a greater importance to standard procedures while dealing with accident prevention and safety. When the emergence of antiretrovirals began, these resources gained prominence in the scenario and they started to be used in high risk accidents, even though no study had yet proven any effectiveness and safety of using ARVs as chemoprophylaxis. The current challenge is the increasing viral resistance to the available antiretroviral drugs: when occupational accidents happens with a HIV-positive patient and it results in resistant strains of the virus, there is a certain difficulty in how to conduct this kind of event with safety. Although several consensus can be found regarding the issue, pieces of information such as drugs toxicity, viral resistance, indicators of ARVs use and the professional support in the treatment should be taken into consideration when the drug is prescribed (or not), working like a prophylactic regimen to the professional who suffers an accident with a HVI-contaminated or a potentially HVI-contaminated material.