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Consulta de profilaxia pós-exposição a VIH : casuística da consulta do serviço de doenças infeciosas do Hospital de Santa Maria no período 2009 - 2014
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Abstract(s)
INTRODUÇÃO A profilaxia pós-exposi ção (PPE) a VIH aplica-se a pessoas que estejam em risco de contrair VIH em contexto ocupacional (PPEO) e não-ocupacional (PPENO) e tem como objetivo evitar a infeção através da administração de medicação antirretroviral. MÉTODOS Análise retrospetiva dos processos clínicos dos utentes da consulta de PPE a VIH no Serviço de Doenças Infeciosas do Hospital Santa Maria entre 2009 e 2014. RESULTADOS Incluíram-se 165 episódios seguidos em consulta de PPEO, 73% mulheres. 82% das exposições foram por via percutânea. 82% dos utentes iniciaram medicação, tendo concluído o esquema inicial 73% destes. Incluíram-se 100 episódios seguidos em consulta de PPENO, 58% homens. 82% das exposições foram sexuais. 81% dos utentes iniciaram PPE, tendo concluído o esquema inicial 55% destes. A medicação mais utilizada foi a combinação de zidovudina, lamivudina e tenofovir (69%). 54% dos utentes que realizaram PPE relataram efeitos adversos. Realizou-se teste VIH, pelo menos três meses pós-exposição a 74% dos utentes que concluíram a PPE. Seroconversão VIH: 0%. DISCUSSÃO E CONCLUSÃO Verificou-se baixa adesão à consulta, com provável eficácia da medicação, uma elevada incidência de efeitos adversos, ainda que de gravidade ligeira, confirmando-se a segurança dos fármacos.
INTRODUCTION Post-exposure prophylaxis (PEP) to HIV is applied to people prone to contracting the disease in either occupational (OPEP) or non-occupational (NOPEP) context, meant to avoid infection through administration of antiretroviral medication. METHODOLOGY A retrospective analysis of clinical files at the PEP-HIV practice at Serviço de Doenças Infeciosas, Hospital Santa Maria was performed. RESULTS 165 episodes followed in OPEP practice were included, 73% of which women. 82% of the exposures were percutaneous. 82% of patients commenced medication, having completed the initial scheme 73% of these. Regarding the NOPEP practice, 100 episodes were included, 58% men. 82% of the exposures were sexual. 81% of patients started PEP, 55% of which completed the initial scheme. The majority (69%) underwent a combination of zidovudine, lamivudine and tenofovir. Adverse effects were reported on 55% of patients that went through PEP. HIV test was made, at least three months post-exposure, to 74% of the users that completed PEP. Seroconversion: 0%. DISCUSSION AND CONCLUSION A low adherence to PEP practice was verified. The medication was found to be probably effective, with a high incidence of low severity adverse effects. The safety of the drugs was confirmed.
INTRODUCTION Post-exposure prophylaxis (PEP) to HIV is applied to people prone to contracting the disease in either occupational (OPEP) or non-occupational (NOPEP) context, meant to avoid infection through administration of antiretroviral medication. METHODOLOGY A retrospective analysis of clinical files at the PEP-HIV practice at Serviço de Doenças Infeciosas, Hospital Santa Maria was performed. RESULTS 165 episodes followed in OPEP practice were included, 73% of which women. 82% of the exposures were percutaneous. 82% of patients commenced medication, having completed the initial scheme 73% of these. Regarding the NOPEP practice, 100 episodes were included, 58% men. 82% of the exposures were sexual. 81% of patients started PEP, 55% of which completed the initial scheme. The majority (69%) underwent a combination of zidovudine, lamivudine and tenofovir. Adverse effects were reported on 55% of patients that went through PEP. HIV test was made, at least three months post-exposure, to 74% of the users that completed PEP. Seroconversion: 0%. DISCUSSION AND CONCLUSION A low adherence to PEP practice was verified. The medication was found to be probably effective, with a high incidence of low severity adverse effects. The safety of the drugs was confirmed.
Description
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016
Keywords
HIV Profilaxia pós-exposição