974 J Med Assoc Thai Vol. 89 No. 7 2006 Correspondence to : Kiertiburanakul S, Department of Medi- cine, Faculty of Medicine Ramathibodi Hospital, Rama 6 Rd, Bangkok 10400, Thailand. Phone: 0-2201-1922, Fax: 0-2201- 2107, E-mail: rasal@mahidol.ac.th J Med Assoc Thai 2006; 89 (7): 974-8 Full text. e-Journal: http://www.medassocthai.org/journal Use of HIV Postexposure Prophylaxis in Healthcare Workers after Occupational Exposure: A Thai University Hospital Setting Sasisopin Kiertiburanakul MD*, Bunchong Wannaying BSc**, Sirirat Tonsuttakul BSc**, Pranee Kehachindawat MSW**, Siriluk Apivanich MSc**, Somporn Somsakul BSc **, Kumthorn Malathum MD* The abstract was presented at the 2nd International Congress of the Asia Pacific Society of Infection Control, February 14-17, 2004, Singapore * Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University **Department of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University Background: PostExposure Prophylaxis (PEP) is widely used after exposures to Human Immunodeficiency Virus (HIV) to reduce the risk of infection in the healthcare setting. Few data are available on the safety and tolerability of Anti Retro Viral drugs (ARV) among Health Care Workers (HCWs) who are prescribed prophylaxis. Objective: To collect information about the safety and compliance of taking ARV for HIV PEP among HCWs. Material and Method: Retrospective review on registry data regarding occupational HIV exposures, the PEP regimens used, and the adverse events associated with PEP was performed. Results: During a five year-period, 820 episodes with occupational blood or body fluid exposures were reported. Nurses (27%) were the largest group at risk. The most common type of exposure was percutaneous injuries (82%). Only 125 (15%) HCWs had occupational exposures to HIV, 64 HCWs were prescribed HIV PEP and 32 (50%) HCWs did not complete the PEP regimen as initially prescribed. The commonly prescribed ARV was zidovudine (38%), lamivudine (33%), and indinavir (11%). Overall, 18 (28%) HCWs reported symptoms while on PEP, such as nausea (89%), vomiting (55%), and dizziness (39%). None of the HCWs had HIV seroconversion. Conclusions: Adverse effects from HIV PEP were very common. Clinicians prescribing HIV PEP need to discuss with HCWs about PEP efficacy and side effects. Education efforts aimed at occupational exposure prevention are still important issues. Keywords: HIV, Postexposure prophylaxis, Health care worker, Antiretroviral drug, Adverse event Health Care Workers (HCWs) are at risk for acquiring Human Immunodeficiency Virus (HIV) fol- lowing an occupational exposure to HIV-contaminated blood. Although universal infection control precau- tions, safer use of needles, and other innovations may substantially reduce the incidence of occupational exposures, this risk cannot be eliminated completely (1) . The average risk of acquiring HIV infection after per- cutaneous and mucous membrane exposure to HIV- infected blood had been estimated as 0.3% and 0.09%, respectively (2,3) . Antiretroviral Post Exposure Prophy- laxis (PEP) is widely used after exposures to HIV to reduce the risk of infection in the healthcare setting (4) . Despite current practice, few data are available on the safety and tolerability of Anti Retro Viral drugs (ARV) among HCWs who are prescribed prophylaxis. Ramathibodi Hospital (an 800 bed-teaching hospital, Bangkok, Thailand) has adopted a policy to