Postexposure prophylaxis for human immunodeficiency virus infection after sexual or injection drug use exposure: identification and characterization of the source of exposure

J Infect Dis. 2001 Dec 15;184(12):1608-12. doi: 10.1086/324580. Epub 2001 Dec 3.

Abstract

In a nonrandomized study of nonoccupational postexposure prophylaxis (PEP), a cross-sectional evaluation of subjects who were the source of human immunodeficiency (HIV) exposure was performed to characterize partners of index subjects seeking nonoccupational PEP against HIV. Among 401 index subjects, 64 (16%) recruited a source subject. Those in a steady relationship and those who knew that the source subject was HIV antibody positive were more likely to recruit their source subject. Source subjects reported high rates of past (78%) and current (69%) antiretroviral use; 46% of those using antiretroviral drugs had detectable plasma HIV-1 RNA levels. Antiretroviral resistance was detected in many source subjects who reported any use of antiretrovirals and was rare among source subjects who reported no history of antiretroviral use. Clinicians often make treatment decisions on the basis of incomplete knowledge of the source subject's HIV status or antiretroviral treatment history. The treatment history, particularly nonuse of a class of antiretroviral drugs, can be used to predict drug resistance.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-HIV Agents / pharmacology
  • Anti-HIV Agents / therapeutic use*
  • Contact Tracing*
  • Cross-Sectional Studies
  • Drug Resistance, Viral / genetics
  • Female
  • HIV Antibodies / blood
  • HIV Infections / drug therapy*
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • HIV-1 / genetics
  • HIV-1 / immunology
  • Humans
  • Male
  • RNA, Viral / blood
  • Sexual Behavior*
  • Substance Abuse, Intravenous*

Substances

  • Anti-HIV Agents
  • HIV Antibodies
  • RNA, Viral