Recommendations for preventing transmission of human immunodeficiency virus, hepatitis B virus to patients during exposure-prone invasive procedures

Article Abstract:

Patients across the nation are concerned about the risk of contracting infection with HIV, the AIDS virus, from doctors and health care workers. Recently, the Centers for Disease Control (CDC) have issued a set of recommendations for preventing the spread of HIV infection and hepatitis B infection to patients. (Hepatitis B is a potentially fatal liver infection that has the same transmission routes as HIV.) The recommendations of the CDC are based upon several scientific findings, which are discussed. The risk of transmission by health care workers who do not perform invasive procedures such as surgery is virtually nil. Infected health care workers who perform invasive procedures while adhering to recommended precautions pose very little risk. Furthermore, the risk of transmitting HIV infection is considerably less than the risk of transmitting hepatitis B. Within 20 clusters of hepatitis B attributable to health care workers, in 12 cases the worker did not wear gloves, nine of these were dentists or oral surgeons. The risk of contracting HIV infection appears to be about 100 times smaller than the risk of contracting hepatitis B infection from a health care worker. The case of a Florida dentist who has infected five patients is remarkable, and the precise route of transmission has not been determined. However, in studies of hundreds of patients treated by several surgeons and dentists who had AIDS, the only patient who was infected with HIV was an intravenous drug user who may have had the infection already. The CDC recommendations suggest that hospitals and medical care groups identify procedures of greatest risk, so called exposure-prone procedures. Such exposure-prone procedures involve the risk of injury to the health care worker, who then may contaminate the patient with his blood. There is no known reason to restrict health workers infected with HIV or hepatitis B from non-exposure prone procedures. It is recommended that workers who perform exposure-prone procedures learn of their own infection status, and that they not perform these procedures if they are infected with either virus. However, the CDC do not recommend mandatory testing for infection with HIV or hepatitis B. (Consumer Summary produced by Reliance Medical Information, Inc.)

HIV (Viruses), HIV, Hepatitis B, Hepatitis B virus

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Update: provisional public health service recommendations for chemoprophylaxis after occupational exposure to HIV

Article Abstract:

Health care workers who are stuck by a hollow needle that was in an HIV-infected patient's vein or artery should be strongly encouraged to take zidovudine, 3TC and/or the protease inhibitor indinavir. They should begin treatment within 1 to 2 hours and take the drugs for 4 weeks. They should be tested for HIV periodically and have blood tests to detect drug toxicity. Studies have shown the risk of seroconversion among health care workers with needle-stick injuries to be 0.3% and in one study, zidovudine reduced the risk of seroconversion by 79%.

Care and treatment, Injuries, Physicians, Medical professions, Work-related injuries, Work related injuries

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Preventing HIV infection in infants and children

Article Abstract:

An estimate of 1800 children worldwide becomes infected with human immunodeficiency virus (HIV), the majority of them newborns. Treatment aimed to prolong life and prevent transmission of the HIV from a mother to her baby is discussed.

United States, Children, Child health

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