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Prophylaxis against possible human immunodeficiency virus exposure after nonoccupational needlestick injuries or sexual assaults in children and adolescents.
Arch Pediatr Adolesc Med. 2001 Jun; 155(6):680-2.AP

Abstract

BACKGROUND

Nonoccupational human immunodeficiency virus (HIV) postexposure prophylaxis (PEP) for adults has been described, although the Centers for Disease Control and Prevention, Atlanta, Ga, offer no specific recommendations. There is limited information about its use in children and adolescents.

OBJECTIVE

To describe the current practices of physicians in pediatric infectious disease (PID) and pediatric emergency medicine (PEM) departments regarding nonoccupational HIV PEP for children and adolescents.

DESIGN

Survey.

PARTICIPANTS

Directors of all PID and PEM departments with fellowship programs in the United States and Canada between July and November 1998.

MAIN OUTCOME MEASURES

General questions regarding HIV PEP and questions concerning 2 scenarios (5-year-old with a needlestick injury and a 15-year-old after sexual assault).

RESULTS

The return rate was 67 (78%) of 86 for PID and 36 (75%) of 48 for PEM physicians. Fewer than 20% of physicians reported institutional policies for nonoccupational HIV PEP; 33% had ever initiated nonoccupational HIV PEP. In both scenarios, PID physicians were more likely than PEM physicians to recommend or offer HIV PEP in the first 24 hours after the incident (55 [83%] of 66 vs 20 [56%] of 36 for needlestick injuries [odds ratio, 4.0; 95% confidence interval, 1.6-10.1] and 47 [72%] of 65 vs 16 [50%] of 32 for sexual assault [odds ratio, 2.6; 95% confidence interval, 1.1-6.3]). Seven different antiretroviral agents in single, dual, or triple drug regimens administered for 2 to 12 weeks were suggested.

CONCLUSIONS

Although few physicians reported institutional policies, and only one third had ever initiated HIV PEP, many would offer or recommend HIV PEP for children and adolescents within 24 hours after possible HIV exposure. A wide variation of regimens have been suggested. There is a need for a national consensus for nonoccupational HIV PEP.

Authors+Show Affiliations

Division of Pediatric Infectious Diseases, Finland 5, Boston Medical Center, 1 Boston Medical Center Place, Boston, MA 02118, USA. franz.babl@bmc.orgNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11386957

Citation

Babl, F E., et al. "Prophylaxis Against Possible Human Immunodeficiency Virus Exposure After Nonoccupational Needlestick Injuries or Sexual Assaults in Children and Adolescents." Archives of Pediatrics & Adolescent Medicine, vol. 155, no. 6, 2001, pp. 680-2.
Babl FE, Cooper ER, Kastner B, et al. Prophylaxis against possible human immunodeficiency virus exposure after nonoccupational needlestick injuries or sexual assaults in children and adolescents. Arch Pediatr Adolesc Med. 2001;155(6):680-2.
Babl, F. E., Cooper, E. R., Kastner, B., & Kharasch, S. (2001). Prophylaxis against possible human immunodeficiency virus exposure after nonoccupational needlestick injuries or sexual assaults in children and adolescents. Archives of Pediatrics & Adolescent Medicine, 155(6), 680-2.
Babl FE, et al. Prophylaxis Against Possible Human Immunodeficiency Virus Exposure After Nonoccupational Needlestick Injuries or Sexual Assaults in Children and Adolescents. Arch Pediatr Adolesc Med. 2001;155(6):680-2. PubMed PMID: 11386957.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylaxis against possible human immunodeficiency virus exposure after nonoccupational needlestick injuries or sexual assaults in children and adolescents. AU - Babl,F E, AU - Cooper,E R, AU - Kastner,B, AU - Kharasch,S, PY - 2001/7/14/pubmed PY - 2001/7/20/medline PY - 2001/7/14/entrez SP - 680 EP - 2 JF - Archives of pediatrics & adolescent medicine JO - Arch Pediatr Adolesc Med VL - 155 IS - 6 N2 - BACKGROUND: Nonoccupational human immunodeficiency virus (HIV) postexposure prophylaxis (PEP) for adults has been described, although the Centers for Disease Control and Prevention, Atlanta, Ga, offer no specific recommendations. There is limited information about its use in children and adolescents. OBJECTIVE: To describe the current practices of physicians in pediatric infectious disease (PID) and pediatric emergency medicine (PEM) departments regarding nonoccupational HIV PEP for children and adolescents. DESIGN: Survey. PARTICIPANTS: Directors of all PID and PEM departments with fellowship programs in the United States and Canada between July and November 1998. MAIN OUTCOME MEASURES: General questions regarding HIV PEP and questions concerning 2 scenarios (5-year-old with a needlestick injury and a 15-year-old after sexual assault). RESULTS: The return rate was 67 (78%) of 86 for PID and 36 (75%) of 48 for PEM physicians. Fewer than 20% of physicians reported institutional policies for nonoccupational HIV PEP; 33% had ever initiated nonoccupational HIV PEP. In both scenarios, PID physicians were more likely than PEM physicians to recommend or offer HIV PEP in the first 24 hours after the incident (55 [83%] of 66 vs 20 [56%] of 36 for needlestick injuries [odds ratio, 4.0; 95% confidence interval, 1.6-10.1] and 47 [72%] of 65 vs 16 [50%] of 32 for sexual assault [odds ratio, 2.6; 95% confidence interval, 1.1-6.3]). Seven different antiretroviral agents in single, dual, or triple drug regimens administered for 2 to 12 weeks were suggested. CONCLUSIONS: Although few physicians reported institutional policies, and only one third had ever initiated HIV PEP, many would offer or recommend HIV PEP for children and adolescents within 24 hours after possible HIV exposure. A wide variation of regimens have been suggested. There is a need for a national consensus for nonoccupational HIV PEP. SN - 1072-4710 UR - https://www.unboundmedicine.com/medline/citation/11386957/Prophylaxis_against_possible_human_immunodeficiency_virus_exposure_after_nonoccupational_needlestick_injuries_or_sexual_assaults_in_children_and_adolescents_ L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/vol/155/pg/680 DB - PRIME DP - Unbound Medicine ER -