Prophylactic treatment and follow-up after exposure to HIV, Hepatitis B and Hepatitis C outside hospital needs to be improved.
Dr Sonder and colleagues from the Netherlands evaluated the policy on infectious diseases in 2003.
The researchers noted that until 2000, people in Amsterdam could report exposure outside hospital to either a hospital or the municipal health service.
The research team stated that if people self-reported to the municipal health service, they were then referred to hospitals for HIV prophylaxis.
The municipal health service handled treatment and follow-up related to Hepatitis B and Hepatitis C and traced sources.
| In nearly 75% of cases the municipal health service traced and tested the source of infection|
|British Medical Journal|
The team observed that for cases reported to a hospital, hospital staff often did not trace HIV sources or follow up patients for Hepatitis B and Hepatitis C.
The investigators state that key measures for improvement are required that provide adequate treatment for HIV, Hepatitis B and Hepatitis C for all reported exposures outside hospital.
The researchers report that a new protocol was introduced in January 2000, in which 3 Amsterdam hospitals and the municipal health service collaborated in the treatment and follow-up of exposures outside of hospital.
According to this new protocol, both municipal health service and hospitals can decide whether HIV prophylaxis is necessary and prescribe accordingly.
The researchers report that all people exposed in the community who go to hospitals are subsequently referred to the municipal health service for further treatment and follow-up.
The research team found this protocol to be effective in that most people comply with treatment and follow-up.
When indicated, HIV prophylaxis is started soon after exposure and in nearly 75% of cases the municipal health service traced and tested the source.
Dr Sonder’s team concludes, “Provision of treatment and follow-up in a single place enables tracing and testing sources.”
“Follow-up includes counseling and registration of all reported exposures in Amsterdam, which allows for swift identification of emerging epidemiological trends.”