Nonoccupational HIV post-exposure prophylaxis: a 10-year retrospective analysis

HIV Med. 2010 Oct 1;11(9):584-92. doi: 10.1111/j.1468-1293.2010.00826.x. Epub 2010 Mar 25.


Background: We conducted a retrospective analysis of administration of nonoccupational HIV post-exposure prophylaxis (nPEP) in a single centre where tracing and testing of the source of exposure were carried out systematically over a 10-year period.

Methods: Files of all nPEP requests between 1998 and 2007 were reviewed. Characteristics of the exposed and source patients, the type of exposure, and clinical and serological outcomes were analysed.

Results: nPEP requests increased by 850% over 10 years. Among 910 events, 58% were heterosexual exposures, 15% homosexual exposures, 6% sexual assaults and 20% nonsexual exposures. In 208 events (23%), the source was reported to be HIV positive. In the remaining cases, active source tracing enabled 298 HIV tests to be performed (42%) and identified 11 HIV infections (3.7%). nPEP was able to be avoided or interrupted in 31% of 910 events when the source tested negative. Of 710 patients who started nPEP, 396 (56%) reported side effects, among whom 39 (5%) had to interrupt treatment. There were two HIV seroconversions, and neither was attributed to nPEP failure.

Conclusions: nPEP requests increased over time. HIV testing of the source person avoided nPEP in 31% of events and was therefore paramount in the management of potential HIV exposures. Furthermore, it allowed active screening of populations potentially at risk for undiagnosed HIV infection, as shown by the increased HIV prevalence in these groups (3.7%) compared with a prevalence of 0.3% in Switzerland as a whole.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use*
  • Contact Tracing*
  • Drug Therapy, Combination
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • HIV Seropositivity / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Needle Sharing / statistics & numerical data
  • Needlestick Injuries / epidemiology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Post-Exposure Prophylaxis / economics
  • Post-Exposure Prophylaxis / statistics & numerical data*
  • Post-Exposure Prophylaxis / trends
  • Practice Guidelines as Topic
  • Retrospective Studies
  • Risk Factors
  • Switzerland / epidemiology
  • Unsafe Sex / statistics & numerical data
  • Young Adult


  • Anti-HIV Agents