To offer or not to offer: A conundrum on ascertaining whether post‐exposure prophylaxis is indicated in occupational exposure of HIV

• Published in: Health science reports 2020-06, Vol.3 (2), p.e152-n/a
• Main Authors: Aribou, Zeenathnisa M., Wijaya, Limin, Hoe, Gan W.
• Format: Article
• Language: English
• Subjects: Correspondence; Cost estimates; Disease transmission; HIV; Human immunodeficiency virus; Infections; Infectious Diseases; Occupational Health; Risk assessment
• ISSN: 2398-8835; 2398-8835
• DOI: 10.1002/hsr2.152

[...]if the source patient is tested and found to be HIV negative in the absence of acute retroviral syndrome, current guidelines recommend that PEP should not be started – or should be discontinued – for the HCW. A recent study reported that cost estimates incurred by healthcare institutions for consultations, laboratory tests, PEP, and hepatitis B vaccinations, if indicated, range from US$450 for low‐risk needlestick injury cases to US$2308 for cases requiring extended follow‐up. Physicians have an obligation to abide by the ethical principle of non‐maleficence and be professionally accountable to make a clinical judgement of what is in the best interest of the affected HCW. [...]existing HIV PEP guidelines for occupationally exposed HCW, whilst useful, cannot be the ‘be‐all and end‐all’, as our society and cultural lens continue to calibrate the attitude and acceptance towards HIV infection, however acquired.