Health care workers (HCWs) are at high risk of occupational exposure to many infections, such as human immunodeficiency virus (HIV). The World Health Organization (WHO) estimated about 3 million occupational exposures in health care settings each year, 90% of which occurred in developing countries. HCWs working in the departments such as operating, delivery, emergency rooms and laboratories suffer from a higher risk of exposure1. It has been estimated that more than 250,000 HCWs were exposed to HIV each year and about 1,000 HIV infections were likely to happen2.
The advent of antiretroviral therapy (ART) has greatly improved the management and prevention of HIV infection3. Postexposure prophylaxis (PEP) has been proved to be a safe and effective treatment strategy aimed at preventing infection in those with recent HIV exposures. Approximately, 81% of the transmission of HIV risk can be reduced using PEP4. Based on the WHO guidelines, all the HCWs are required to use PEP after HIV occupational exposures4.
Pre-exposure prophylaxis (PrEP), the usage of antiretroviral medications in HIV-uninfected individuals to prevent acquisition of HIV, has been identified to be sufficient and safe for HIV prevention through case-control, observational and randomized clinical trial data5. In 2014, WHO recommended PrEP as a critical part of comprehensive HIV prevention. In 2015, the use of PrEP was further expanded from men who have sex with men (MSM) to all HIV high-risk populations 6. However, the use of PrEP in HIV occupational exposure has not been reported.
Herein, we described the first reported use of combination of PrEP and PEP in a surgeon who was occupationally exposed to HIV during operation.