A Novel Explanation for PEP Failure?

HIV sequence analysis in a case of occupational postexposure prophylaxis failure suggests HIV persistence as a potential cause.

The use of postexposure prophylaxis (PEP) after occupational HIV exposure reduces the risk for HIV acquisition by >80%. PEP failure, when it occurs, is usually attributed to delayed initiation, transmitted drug resistance, or suboptimal medication adherence. What could be the explanation in situations when none of these factors appears to be the main cause of failure?

To answer this question, researchers examined the case of a healthcare worker (HCW) in Australia who sustained a needlestick injury involving a small amount of injected blood from a source patient with an HIV viral load >100,000 copies/mL. The HCW initiated a PEP regimen of AZT, 3TC, and indinavir within 2 hours of exposure and completed 4 weeks of therapy, during which she had…

Reviewing Author

Jonathan Z. Li, MD

A Novel Explanation for PEP Failure?

Topics

Reviewing Author