Occupational Exposure To Human Immuno Deficiency Virus (HIV) And Post Exposure Prophylaxis (PEP) Delivered At The Child Health Pharmacy Of Korle Bu Teaching Hospital (KBTH)

Background: Healthcare workers around the globe are at an increased risk of exposure to HIV. Post-exposure prophylaxis (PEP) is the use of short-term antiretroviral therapy (ART) to reduce the risk of HIV infection following exposure. This study reviewed all the cases of occupational exposure reporting at the Child Health Pharmacy of KBTH between January 2015 and December 2017.

Method: All needle sticks and sharp injuries (NSSI) at the Child Health Department of KBTH report at the Pharmacy for management. Risk assessment is first done and PEP is administered based on the WHO and KBTH protocols. Cases are followed up with repeat laboratory investigations at 3 months. All cases are carefully recorded together with copies of the laboratory results. This data was extracted manually onto an excel sheet and imported into STATA for analysis. Analysis was limited to descriptive statistics.

Results and discussion: A total of 54 cases were recorded with 32 doctors, 6 nurses, 11 orderlies and 5 other allied professionals.  There were more female (56%) than male (44%) cases with a mean age of 28 years.  All cases were reported within 72 hours of exposure and 35% were reported within 24 hours. Nearly all the cases (96.2%) were due to NSSI with 3.8% due to splashes. Of the 29 cases who qualified for PEP, 38% took combivir only (lamivudine/zidovudine) while 62% took combivir and aluvia (lopinavir and ritonavir). A total of 90% completed the 28 day course while 10% stopped after the risk was determined to be too low to continue. All 54 cases tested negative for HIV at the 3 month follow up testing.

Conclusion: The current system of tracking and treating occupational exposure to HIV at the Child Health Department appears effective with doctors being the most at risk professionals. Periodic monitoring and evaluation of the current system are recommended.