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HIV Prophylaxis Is Often Halted Prematurely Or Started Too Late
August 27, 1997
For more than one year, a number of British Columbia emergency rooms have been offering postexposure prophylaxis to firefighters, police officers and others who have been exposed to HIV.
The most frequently encountered difficulties associated with the program are drug intolerance and delays in initiation of treatment. Another problem, according to Dr. Alistair McLeod of the Center for Excellence in HIV/AIDS in Vancouver, British Columbia, is that about half of the patients discontinue treatment early.
High rates of early discontinuation are also reported by US hospitals, and the problem appears to pertain to individuals treated following occupational exposure, as well. According to Dr. Mitch Katz of the San Francisco Department of Health in California, only about half of those treated at San Francisco General Hospital following occupational exposure to HIV completed a 28-day regimen.
Meanwhile, Dr. Kenneth Mayer of Brown University in Providence, Rhode Island, who focused on late initiation of prophylactic treatment, estimates that about half of the 30 individuals he studied who sought postexposure prophylaxis came in more than 72 hours after exposure to HIV, the maximum time most researchers say postexposure prophylaxis remains effective.
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