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      936Tolerability, Adherence and Completion of New Occupational HIV Post-Exposure Prophylaxis Regimens (Tenofovir + Emtricitabine and Raltegravir)

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          Abstract

          Background.  Several studies suggest that HIV acquisition can be reduced significantly with antiretroviral post-exposure prophylaxis (PEP). Recently the recommended occupational HIV PEP regimen was changed by CDC and New York State Department of Health to tenofovir + emtricitabine and raltegravir (TNF/FTC/RAL), principally to lessen side effects and simplify regimen choices. Studies of TNF/FTC/RAL in non-occupational PEP have shown the regimen to be well tolerated and better completed, but there are no studies to date in an occupational setting. The goal of this study is to compare the newly recommended occupational HIV PEP regimen to prior regimens in terms of tolerability, adherence, and completion rates in exposed healthcare workers. Methods.  In this retrospective case control study, we reviewed the charts of 160 employees at risk for HIV infection due to occupational exposure at Montefiore Medical Center in the Bronx NY from 2007-2013. We assessed risk of the exposure, initial PEP regimen, changes in regimen, rates of completion, costs, and side effects due to medications. Results.  Of the 160 employees, 153 had initial and follow-up information. Of these, 93 initially started on zidovudine + lamivudine and lopinavir/ritonavir (ZDV/3TC/LPV) were compared to 48 initially started on TNF/FTC/RAL. 40 of 93 (43%) of those in the ZDV/3TC/LPV group completed 4 weeks of therapy vs 31 of 48 (65%) of those in the TNF/FTC/RAL group (p = 0.015). 68 of 93 (73%) of employees receiving ZDV/3TC/LPV reported side effects, compared to 27 of 48 (56%) of those receiving TNF/FTC/RAL (p = 0.043). Further analyses will be presented at the meeting. Conclusion.  Employees receiving tenofovir + emtricitabine and raltegravir for occupational HIV post-exposure prophylaxis were more likely to complete the recommended 4 week course of therapy, and reported fewer side effects than those who received the prior recommended regimen of zidovudine + lamivudine and lopinavir/ritonavir. Tenofovir + emtricitabine and raltegravir appears to be superior to older regimens in key parameters critical to the success of occupational PEP programs. Disclosures.   All authors: No reported disclosures.

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          Author and article information

          Journal
          Open Forum Infect Dis
          Open Forum Infect Dis
          ofid
          ofids
          Open Forum Infectious Diseases
          Oxford University Press
          2328-8957
          December 2014
          December 2014
          : 1
          : Suppl 1 , IDWeek 2014 Abstracts
          : S272
          Affiliations
          [1 ]Infectious Diseases, Montefiore Medical Center, Bronx, NY
          [2 ]Infectious Diseases, Albert Einstein College of Medicine, Bronx, NY
          [3 ]Occupational Health, Albert Einstein College of Medicine, Bronx, NY
          [4 ]Occupational Health, Montefiore Medical Center, Bronx, NY
          Author notes

          Session: 114. Occupational Health

          Friday, October 10, 2014: 12:30 PM

          ofu052
          10.1093/ofid/ofu052.644
          5782235
          © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America
          Product
          Categories
          IDWeek 2014 Abstracts
          Poster Abstracts

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