We report an extreme case of high-grade needlestick exposure of a health-care worker to serum from multiple HIV-infected patients after trying to prematurely remove the respective tubes from an automated biochemical analyser. After review of the medical records of the eight source patients, we offered the health-care worker an expanded postexposure prophylaxis regimen including the entry inhibitor enfuvirtide. She refused to take subcutaneous injections, so we recommended the use of the integrase inhibitor raltegravir. She completed therapy without problems and periodic evaluation for HIV transmission up to nine months after the incident was negative.
SiegelMO, KanVL, BenatorDA. Raltegravir for postexposure prophylaxis following occupational exposure to HIV. AIDS2008;22:2552–3
2.
JohnsonS, BaraboutisJG. Adverse effects associated with use of nevirapine in HIV postexposure prophylaxis for 2 health care workers. JAMA2000;284:2722–3
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Brennan-BensonP, PakianathanM, RiceP, Enfurvitide prevents vertical transmission of multidrug-resistant HIV-1 in pregnancy but does not cross the placenta. AIDS2006;20:297–9
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MechaiF, QuertainmontY, SahaliS, DelfraissyJF, GhosnJ. Post-exposure prophylaxis with a maraviroc-containing regimen after occupational exposure to a multi-resistant HIV-infected source person. J Med Virol2008;80:9–10
