Occupational exposure to human immunodeficiency virus: what healthcare providers should know.
OBJECTIVE
The author reviews the risks of occupational exposure to HIV and provides a rationale for new postexposure guidelines for healthcare workers.


BACKGROUND
Approximately 50,000 percutaneous exposures occur yearly among healthcare workers in the United States. Of these, approximately 5000 involve exposures to blood that is known to be infected with HIV. The risk of transmission after percutaneous exposure to HIV-tainted blood has been estimated to be 0.3%, but the risk may be considerably higher to the healthcare worker if any of the following is present: a deep injury; visible blood on the sharp device; a procedure that involves a needle placed in the patient's artery or vein; and a patient with advanced AIDS. The increasing resistance of HIV strains to antiretroviral therapy continues to make treatment more difficult.


CONCLUSIONS
Postexposure prophylaxis with zidovudine may reduce the risk of occupational infection by 80%. Advances in the ability to ameliorate HIV transmission rates and to treat individuals with resistant disease through innovations in drug therapy, engineering of controls for injury prevention, and more focused postexposure evaluation offer the hope of reducing this infrequent, but dangerous, occupational threat.
Aboulafia
D M
DM
Section of Hematology/Oncology, Virginia Mason Medical Center, Division of Hematology, University of Washington, Seattle, USA.
D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data*; D009784:Occupational Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D016273:Occupational Exposure / Q000517:prevention & control* / Q000706:statistics & numerical data*; D011159:Population Surveillance; D014481:United States / Q000453:epidemiology