title: The risk of needle stick accidents during surgical procedures: HIV-1 viral load in blood and bone marrow.
abstract: Health-care workers are at risk to acquire HIV through occupational exposure to blood of HIV-infected patients. The mean risk after a percutaneous exposure is approximately 0.3%. A large inoculum and a source patient with a high plasma viral load increases the transmission risk. To ensure the safety of the operating team, we try to reduce HIV viral load in plasma prior to high-risk interventions (cardiothoracic and orthopaedic surgery). However, in 15.7% of the exposures occurring in the operating room, the possible source material is bone marrow. To make more accurate exposure risk assessments, we measured HIV-1 RNA in both plasma and bone marrow of five HIV-infected patients undergoing surgery. We found that the plasma viral load was not different from the viral load in bone marrow.
authors.affiliation: Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis, PO Box 95500, 1090 HM Amsterdam, The Netherlands. r.m.regez@olvg.nl
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Regez
authors.forename: Arthur E
authors.initials: AE
authors.lastname: Kleipool
authors.forename: Ron G
authors.initials: RG
authors.lastname: Speekenbrink
authors.forename: P H Jos
authors.initials: PH
authors.lastname: Frissen
mesh_terms: D001853:Bone Marrow / Q000821:virology; D013502:General Surgery; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology / Q000635:transmission*; D015528:HIV Seroprevalence; D015497:HIV-1 / Q000502:physiology*; D006282:Health Personnel; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D016602:Needlestick Injuries / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure; D012307:Risk Factors; D019562:Viral Load