Skip to main content
    • Aa
    • Aa

Experience of Healthcare Workers Taking Postexposure Prophylaxis After Occupational HIV Exposures: Findings of the HIV Postexposure Prophylaxis Registry

  • David Weber, Susan A. Wang (a1) (a2), Adelisa L. Panlilio (a1), Peggy A. Doi (a3), Alice D. White (a4), Michael Stek (a5), Alfred Saah (a5) and HIV PEP Registry Group...

To collect information about the safety of taking antiretroviral drugs for human immunodeficiency virus (HIV) postexposure prophylaxis (PEP).


A voluntary, confidential registry.


Hospital occupational health clinics, emergency departments, private physician offices, and health departments in the United States.


492 healthcare workers (HCWs) who had occupational exposures to HIV, were prescribed HIV PEP, and agreed to be enrolled in the registry by their healthcare providers were prospectively enrolled in the registry. Three hundred eight (63%) of 492 of the PEP regimens prescribed for these HCWs consisted of at least three antiretroviral agents. Of the 449 HCWs for whom 6-week follow-up was available, 195 (43%) completed the PEP regimen as initially prescribed. Forty-four percent (n=197) of HCWs discontinued all PEP drugs and did not complete a PEP regimen. Thirteen percent (n=57) discontinued ≥1 drug or modified drug dosage or added a drug but did complete a course of PEP. Among the 254 HCWs who modified or discontinued the PEP regimen, the two most common reasons for doing so were because of adverse effects attributed to PEP (54%) and because the source-patient turned out to be HIV-negative (38%). Overall, 340 (76%) HCWs with 6-week follow-up reported some symptoms while on PEP: nausea (57%), fatigue or malaise (38%), headache (18%), vomiting (16%), diarrhea (14%), and myalgias or arthralgias (6%). The median time from start of PEP to onset of each of the five most frequently reported symptoms was 3 to 4 days. Only 37 (8%) HCWs with 6-week follow-up were reported to have laboratory abnormalities; review of the reported abnormalities revealed that most were unremarkable. Serious adverse events were reported to the registry for 6 HCWs; all but one event resolved by the 6-month follow-up visit. Fewer side effects were reported by HCWs taking two-drug PEP regimens than by HCWs taking three-drug PEP regimens.


Side effects from HIV PEP were very common but were rarely severe or serious. The nature and frequency of HIV PEP toxicity were consistent with information already available on the use of these antiretroviral agents. Clinicians prescribing HIV PEP need to counsel HCWs about PEP side effects and should know how to manage PEP toxicity when it arises.

Corresponding author
Mailstop EO2, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

3. DM Cardo , DH Culver , CA Ciesielski , PU Srivastava , R Marcus , D Abiteboul , et al. A case-control study of HIV seroconversion in health care workers after percutaneous exposure. Centers for Disease Control and Prevention Needlestick Surveillance Group. N Engl J Med 1997;337:14851490.

4. EM Connor , RS Sperling , R Gelber , P Kiselev , G Scott , MJ O'Sullivan , et al. Reduction of maternal infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med 1994;331:11731180.

5. CC Tsai , KE Follis , A Sabo , TW Beck , RF Grant , N Bischofberger , et al. Prevention of SIV infection in macaques by (R)-9-(2-phosphonyl-methoxypropyl) adenine. Science 1995;270:11971199.

6. D Böttiger , NG Johansson , B Samuelsson , H Zhang , P Putkonen , L Vrang , et al. Prevention of simian immunodeficiency virus, SIVsm, or HrV-2 infection in cynomolgus monkeys by pre- and postexposure administration of BEA-005. AIDS 1997;11:157162.

7. DJ Manion , MS Hirsch . Combination chemotherapy for human immunodeficiency virus-1. Am J Med 1997;102(suppl 5B):7680.

8. A Lafeuillade , C Poggi , C Tamalet , N Profizi , C Tourres , O Costes . Effects of a combination of zidovudine, didanosine, and lamivudine on primary human immunodeficiency virus type 1 infection. J Infect Dis 1997;175:10511055.

10. JI Tokars , R Marcus , DH Culver , CA Schable PS McKibben , CI Bandea , et al. Surveillance of HIV infection and zidovudine use among health care workers after occupational exposure to HIV-infected blood. The CDC Cooperative Needlestick Surveillance Group. Ann Intern Med 1993;118:913919.

14. KA Sepkowitz , P Rivera , J Louther , S Lim , B Pryor . Postexposure prophylaxis for human immunodeficiency virus: frequency of initiation and completion of newly recommended regimen. Infect Control Hosp Epidemiol 1998;19:506508.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 12 *
Loading metrics...

Abstract views

Total abstract views: 194 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 18th August 2017. This data will be updated every 24 hours.