Transmission of HIV-associated tuberculosis to healthcare workers.
OBJECTIVE
A retrospective investigation was made to compare the occupational risk of tuberculosis in personnel assisting human immunodeficiency virus (HIV)-infected and uninfected subjects with active tuberculosis.


METHODS
We retrospectively reviewed 6 years of hospital activity in 3 units where HIV-infected patients with tuberculosis are hospitalized and in 2 units where non-HIV-infected tuberculosis patients are hospitalized. The risk of occupational tuberculosis in healthcare workers who assisted HIV-infected and non-HIV-infected patients with tuberculosis was investigated.


METHODS
The risk of occupational tuberculosis in healthcare workers was studied by considering the numbers of potential source cases (hospitalized patients with tuberculosis) in the two conditions investigated (HIV-positive and HIV-negative). Both potential source cases and cases of tuberculosis in healthcare workers had to be microbiologically proven in order to be considered.


RESULTS
Seven cases of tuberculosis occurred in persons who cared for 85 HIV-infected subjects with tuberculosis, while only 2 cases occurred in staff members who took care of 1,079 HIV-negative tuberculosis patients over the same period (relative risk = 44.4; 95% confidence interval = 8.5-438).


CONCLUSIONS
Tuberculosis seems no longer to be a neglectable risk in healthcare workers assisting patients with HIV infection. Further study is urgently needed to see whether such unexpectedly high dissemination of tuberculosis also is demonstrable in the community.
Di Perri
G
G
Institute of Immunology and Infectious Diseases, University of Verona, Italy.
Cadeo
G P
GP
Castelli
F
F
Micciolo
R
R
Bassetti
S
S
Rubini
F
F
Cazzadori
A
A
Marocco
S
S
Carlotto
A
A
Adami
T
T
D015658:HIV Infections / Q000150:complications*; D006679:HIV Seropositivity; D006760:Hospitalization; D006801:Humans; D017053:Infection Control; D007558:Italy / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*