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- Title
Risk for occupational transmission of human immunodeficiency virus type 1 (HIV-1) associated with clinical exposures. A prospective evaluation.
- Authors
Henderson, David K.; Fahey, Barbara J.; Willy, Mary; Schmitt, James M.; Carey, Kathleen; Koziol, Deloris E.; Lane, H. Clifford; Fedio, Joan; Saah, Alfred J.; Henderson, D K; Fahey, B J; Willy, M; Schmitt, J M; Carey, K; Koziol, D E; Lane, H C; Fedio, J; Saah, A J
- Abstract
<bold>Objectives: </bold>To summarize the results of a 6-year, ongoing, prospective study of the risk for human immunodeficiency virus type 1 (HIV-1) transmission among health care workers, and to estimate the magnitude of the risk for HIV-1 infection associated with different types of occupational exposures.<bold>Design: </bold>Prospective cohort study; the median follow-up for employees sustaining parenteral exposures was 30.2 months (range, 6 to 69 months).<bold>Subjects: </bold>Health care workers at the Clinical Center, National Institutes of Health, including those reporting parenteral and nonparenteral occupational exposures to HIV-1.<bold>Measurements and Main Results: </bold>One thousand three hundred and forty-four clinical health care workers reported 179 percutaneous and 346 mucous membrane exposures to fluids from HIV-1-infected patients during a 6-year period. Responding to a supplementary questionnaire, 559 of these workers reported 2712 cutaneous exposures to blood from HIV-1-infected patients and more than 10,000 cutaneous exposures to blood from all patients during a 12-month period. Occupational transmission of HIV-1 occurred in a single worker after a parenteral exposure to blood from an HIV-1-infected patient. No infections occurred after either mucous membrane or cutaneous exposures to blood from HIV-1-infected patients. Use of newer diagnostic technologies (for example, antigen detection, gene amplification) has not resulted in the identification of occupationally transmitted seronegative infections.<bold>Conclusions: </bold>Combining our results with those of other prospective studies, the risk for HIV-1 transmission associated with a percutaneous exposure to blood from an HIV-1-infected patient is approximately 0.3% per exposure (95% CI, 0.13% to 0.70%); the risks associated with occupational mucous membrane and cutaneous exposures are likely to be substantially smaller. These data support the use of barrier precautions and suggest a need for strategies that change health care providers' attitudes and behaviors.
- Subjects
UNITED States; HIV infections; OCCUPATIONAL diseases; BLOODBORNE infections; HIV infection transmission; ENZYME-linked immunosorbent assay; HIV; WORK-related injuries; LONGITUDINAL method; MEDICAL personnel; PENETRATING wounds; VIRAL antibodies; NATIONAL Institutes of Health (U.S.); RELATIVE medical risk; DISEASE complications
- Publication
Annals of Internal Medicine, 1990, Vol 113, Issue 10, p740
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-113-10-740