Enjeux et mise en place des consultations PrEP au CHU de Bordeaux en 2016, état des lieux à un an

Abstract : Introduction: pre-exposure prophylaxis (PrEP) is authorized in France since January 2016. Our objective was to describe issues and the implementation of the consultations, as well as the data extracted from the follow-up of the users in particular concerning the STIs, of which Mycoplasma genitalium (Mg). Materials and methods: user files included from 27/01/16 to 28/02/17 were analyzed. Included persons had at least one indication to PrEP. Data on STIs were studied until 31/05/17. The consultations took place on two different sites: CHU Pellegrin and Saint-André. Results : the files of 89 users were studied. No seroconversion under PrEP was diagnosed. The median age was 34.1 years. The median follow-up was 3.9 months (IQI: 2.3 - 6.9). 94% of users were reported for PrEP due to unprotected anal intercourse. 36% of the users practiced the "chemsex". 49.4% had at least two indications. 72% reported having at least one history of STIs. At least one STI was diagnosed in 44% of individuals during follow-up. The incidence of STIs was 46.2% person-years. Eighteen cases of Mg were diagnosed over the period, 50% of the strains were resistant to macrolides, two of which were acquired after first-line treatment with macrolides. HAV and HBV vaccination was initiated for 37.2% and 41.7% of non-immunized users, respectively. No significant impairment of renal function was observed. Conclusion : PrEP users are at very high sexual risk. The frequent practice of chemsex is problematic, a specific follow-up in addictology could be beneficial. PrEP monitoring allows for extensive vaccination for HAV and HBV in highly exposed individuals. Screening and systematic treatment of STIs including Mg is essential. The resistance to macrolides for Mg is high.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01591627
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Thursday, September 21, 2017 - 4:26:58 PM
Last modification on : Friday, October 27, 2017 - 1:15:46 AM

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Matthieu Deborde. Enjeux et mise en place des consultations PrEP au CHU de Bordeaux en 2016, état des lieux à un an. Médecine humaine et pathologie. 2017. ⟨dumas-01591627⟩

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