@article{ref1,
title="Two, three, and four-drug regimens for HIV post-exposure prophylaxis in a North American sexual assault victim population",
journal="American journal of emergency medicine",
year="2017",
author="Kumar, Thara and Sampsel, Kari and Stiell, Ian G.",
volume="35",
number="12",
pages="1798-1803",
abstract="BACKGROUND/OBJECTIVES: Due to perceived increased tolerability and compliance, and decreased cost, recent trends in practice are moving towards using fewer drugs for HIV post-exposure prophylaxis. However, there is limited literature to assess this is in the North American sexual assault victim population. <br><br>METHODS: This retrospective before-and-after cohort study compared patients seen at a sexual assault care facility before and after the introduction of two and three-drug post-exposure prophylaxis regimens. Our primary outcome was completion of the 28-day regimen. Secondary objectives included HIV seroconversion rates and patient reported side effects. <br><br>RESULTS: Six-hundred-thirty charts from a 2-year period were reviewed, and 429 met inclusion criteria. There was no difference in completion rates of post-exposure prophylaxis between the two cohorts (50.5% vs. 51.6%). However, there were fewer reported side effects (72.2% vs. 17.6%) in the later cohort. We subsequently compared all patients in either cohort who received four-drug therapy (N=128) versus those who received two or three-drug regimens (N=47). The two or three-drug regimen group had a higher completion rate (66.0% vs. 42.2%; p=0.03), and a lower rate of reported side effects (19.1% vs. 53.9%), specifically for nausea (12.8% vs. 36.7%), constipation (0% vs. 7.9%), diarrhea (2.1% vs. 21.1%), mood changes (0% vs. 10.9%), headache (2.1% vs. 16.4%), and fatigue (6.4% vs. 26.6%). There were no HIV seroconversions in either group. <br><br>CONCLUSION: Two and three-drug HIV post-exposure prophylaxis regimens are better tolerated by patients and associated with greater compliance than four-drug therapy, and could be considered in the sexual assault victim population.<br><br>Copyright © 2017. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0735-6757",
doi="10.1016/j.ajem.2017.05.054",
url="http://dx.doi.org/10.1016/j.ajem.2017.05.054"
}