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Infection Control and Hospital Epidemiology Publication Info

Article DOI: 10.1086/502178
Stable URL: http://www.jstor.org/stable/10.1086/502178
Occupationally Acquired Human Immunodeficiency Virus (HIV) Infection: National Case Surveillance Data During 20 Years of the HIV Epidemic in the United States • 
Ann N. Do , MD, Carol A. Ciesielski , MD, Russ P. Metler , JD, MSPH, Teresa A. Hammett , MPH, Jianmin Li , DPE, MEd and Patricia L. Fleming , PhD
Infection Control and Hospital Epidemiology , Vol. 24, No. 2 (February 2003), pp. 86-96
Article DOI: 10.1086/502178
Article Stable URL: http://www.jstor.org/stable/10.1086/502178
Original Articles

Occupationally Acquired Human Immunodeficiency Virus (HIV) Infection: National Case Surveillance Data During 20 Years of the HIV Epidemic in the United States

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Abstract(back to top)

OBJECTIVE. To characterize occupationally acquired human immunodeficiency virus (HIV) infection detected through case surveillance efforts in the United States.

DESIGN. National surveillance systems, based on voluntary case reporting.

SETTING. Healthcare or laboratory (clinical or research) settings.

PATIENTS.  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.

Bibliographic Information(back to top)

  • Occupationally Acquired Human Immunodeficiency Virus (HIV) Infection: National Case Surveillance Data During 20 Years of the HIV Epidemic in the United States
  • Ann N. Do , MD, Carol A. Ciesielski , MD, Russ P. Metler , JD, MSPH, Teresa A. Hammett , MPH, Jianmin Li , DPE, MEd and Patricia L. Fleming , PhD
  • Infection Control and Hospital Epidemiology
  • Vol. 24, No. 2 (February 2003) (pp. 86-96)

Author Information(back to top)

Ann N. Do , MD; Carol A. Ciesielski , MD; Russ P. Metler , JD, MSPH; Teresa A. Hammett , MPH; Jianmin Li , DPE, MEd; Patricia L. Fleming , PhD

Notes and References(back to top)

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Notes

The authors are from the Surveillance Branch, Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia. Dr. Ciesielski is currently with the Epidemiology and Surveillance Branch, Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention. Mr. Metler is currently with the Office of the Director, Centers for Disease Control and Prevention. Address reprint requests to Ann Do, MD, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E‐47, Atlanta, GA 30333. The authors thank the HIV/AIDS surveillance personnel at state and local health departments for their valuable roles in monitoring cases of occupationally acquired HIV infection and Drs. Elise Beltrami, Adelisa Panlilio, and Denise Cardo and Ms. Linda Chiarello for their helpful comments on this manuscript.

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© 2003 by The Society for Healthcare Epidemiology of America. All rights reserved.