title: Occupationally acquired human immunodeficiency virus (HIV) infection: national case surveillance data during 20 years of the HIV epidemic in the United States.
abstract: OBJECTIVE
  To characterize occupationally acquired human immunodeficiency virus (HIV) infection detected through case surveillance efforts in the United States.
  
  
  METHODS
  National surveillance systems, based on voluntary case reporting.
  
  
  METHODS
  Healthcare or laboratory (clinical or research) settings.
  
  
  METHODS
  Healthcare workers, defined as individuals employed in healthcare or laboratory settings (including students and trainees), who are infected with HIV.
  
  
  METHODS
  Review of data reported through December 2001 in the HIV/AIDS Reporting System and the National Surveillance for Occupationally Acquired HIV Infection.
  
  
  RESULTS
  Of 57 healthcare workers with documented occupationally acquired HIV infection, most (86%) were exposed to blood, and most (88%) had percutaneous injuries. The circumstances varied among 51 percutaneous injuries, with the largest proportion (41%) occurring after a procedure, 35% occurring during a procedure, and 20% occurring during disposal of sharp objects. Unexpected circumstances difficult to anticipate during or after procedures accounted for 20% of all injuries. Of 55 known source patients, most (69%) had acquired immunodeficiency syndrome (AIDS) at the time of occupational exposure, but some (11%) had asymptomatic HIV infection. Eight (14%) of the healthcare workers were infected despite receiving postexposure prophylaxis (PEP).
  
  
  CONCLUSIONS
  Prevention strategies for occupationally acquired HIV infection should continue to emphasize avoiding blood exposures. Healthcare workers should be educated about both the benefits and the limitations of PEP, which does not always prevent HIV infection following an exposure. Technologic advances (eg, safety-engineered devices) may further enhance safety in the healthcare workplace.
authors.affiliation: Surveillance Branch, Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Center for Disease Control and Prevention, 1600 Clifton Road NE, MS E-47, Atlanta, GA 30333, USA.
authors.forename: Ann N
authors.initials: AN
authors.lastname: Do
authors.forename: Carol A
authors.initials: CA
authors.lastname: Ciesielski
authors.forename: Russ P
authors.initials: RP
authors.lastname: Metler
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Hammett
authors.forename: Jianmin
authors.initials: J
authors.lastname: Li
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Fleming
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D017848:Blood-Borne Pathogens; D002487:Centers for Disease Control and Prevention, U.S.; D018563:Disease Notification; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006679:HIV Seropositivity / Q000276:immunology; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000032:analysis / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016602:Needlestick Injuries / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology; D016273:Occupational Exposure / Q000517:prevention & control / Q000706:statistics & numerical data*; D011159:Population Surveillance; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D015483:HIV Antibodies