Antiretroviral prophylaxis after non-occupational exposure to HIV in Abidjan (Cote d'Ivoire)

Objective: The aim of this study was to assess the tolerability and adherence to all non-occupational post-exposure prophylaxis (PEP) for cases of HIV exposure in Abidjan. Method: We retrospectively studied all post-exposure prophylaxis for non-occupational exposures to HIV prescribed from January 1st, 2000 to December 31st, 2007 in the Abidjan infectious diseases department. We analyzed the types of exposure, socio-demographic characteristics of patients, antiretroviral therapy regimens, adherence and tolerability, duration of the treatment, and post-exposure follow-up. Results: Over these eight years, we managed 128 consultations for non-professional exposures to HIV (50 male [39 %], 78 female patients [61 %]), average age 24.8 years (four-54 years). The most frequent exposures were due to rape (n=74), condom rupture (n=29), and occasional unprotected sex (n=21). The average delay before consultation was 20.8 hours. The antiretroviral chemoprophylaxis included a protease inhibitor in 93 % of the cases; 80.5 % of patients completed 28 days of chemoprophylaxis, while 8.6 % interrupted the treatment, and 10.9 % were lost to follow-up. The most frequent adverse effects were gastrointestinal, reported by 79 patients (61.7 %). Only 34 patients (26.6 %) returned for clinical and biological post-exposure follow-up with HIV control at third month, without documented seroconversion. Conclusion: Cases of sexual exposure to HIV are the main indication for post-exposure prophylaxis in Abidjan, except for occupational exposure to blood. However, post-exposure prophylaxis should be available in the units of primary care, such as emergencies departments. © 2010 Elsevier Masson SAS.