Greek AIDS Conference

[WePeC4317] Epidemiological Analysis of HIV Occupational Exposure in Health Care Workers (HCWs)

S. Oliva¹,?A. Ca?izal²,?D. Pugliese³,?L. Redini⁴,?J. Benetucci^5
1?Tte. Gral Per?n 1740 3? E, (1037) Capital Federal, Argentina,?²?Buenos Aires, Argentina,?³?Buenos Aires, Argentina,?⁴?Buenos Aires, Argentina,?⁵?Buenos Aires, Argentina

Objetive:?To describe the epidemiological features of work accident and to asses the effectiveness of post exposure prophylaxis(PEP)-
Methods:?Prospective study in 49 HCWs from October 1998 to December 1999. Baseline serology was carried out through EIA; NESTED PCR for 3 genes and Ag p24/ICD at 4th weeks, serology at 12th, 24 th and 48 th weeks. Standard questionnaire was used.
Results:?36/49 (73.5%) work accidents were suffered by women and 13/49 (26.5%) were men. Average age: 33.4(rate 20-55).Occupations: Physicians: 32.6%, nurses:32.6%, laboratory technicians: 8.1%, dentist: 4%,assistant surgery: 4%, biochemists 2%, students:10.2%, others: 6.1%. Exposure: Needle injuries: 85.6%,(deep :22.4%,superficial : 6.1%),cut:6.1%, mucosal exposure:8.1%Contact with visible fluid: blood: 44.9%, respiratory secretions: 6.1%, tissues: 4%, lost information:12.2%, without contact: 32.6%. Elements: Hollow needle: 77.5%, solid needle: 6.1%, glass: 6.1%, scalpel: 2%. Barrier methods: Yes:85.7%, no: 8.2%, lost information: 6.1%. HBV vaccine: Yes: 40.8%, no: 46.9%, incomplete: 4 %, lost information: 8.1%. Source: HIV positive: 36.7%, negative: 16.3%, unknown: 46.9%. Site: Clinical ward: 38.8%,surgery:16.3%, emergency department:14.3%, laboratory:12.4%, pathological anatomy: 2%, intensive care: 8.1%, dental consulting room: 4%, pathological waste area: 4%. PEP: 13/34(3821/34.2%) have received: 2 nucleoside reverse transcriptasa inhibitors (NRTI) and 21/34(61.7%) 2 NRTI plus protease inhibitor (PI). Period between HCWs and PEP:14 hrs(range half hour-72 hours). Only 12/49(24.5%) have completed the follow up. Nobody seroconversion at this moment.
Conclusions:?The most exposed sex was female. Nurses and doctors were the most frequently exposed. Needle injuries prevailed. High frequent in clinical wards and surgery. Low percentage of HBV vaccine In general, well observance of biosafety recommendations. Delay of the PEP. Incomplete follow up.

Presenting author:?S. Oliva,Tte. Gral Per?n 1740 3? E, (1037) Capital Federal, Argentina; Telephone +(5411) 43072-0774/(5411) 4306-; Fax +(5411) 4372-0774/(5411)4306-06; Email

[WePeC4316] Exposure of health care workers (HCW) to HIV: analysis of 368 cases from a US community teaching hospital 1997-1999

J. Stephens¹,?N. Dunham²,?D. Jackson^3
1?Mercer University S.O.M., 777 Hemlock Street, PO Box 6000-Hosp Box 79, Macon, GA 31208-6000, United States,?²?Medical Center of Central GA, Macon, United States,?³?Medical Center of Central GA, Macon, United States

Objective:?Review the incidence, outcomes and adherence with post-exposure prophylaxis (PEP)in the US Public Health Service guidelines era.
Methods:?368 occupational exposures were reviewed from our employee health database for type of injury, time to starting PEP, adherence with regimen and followup. Yearly exposures ranged from 120-127. Proportion taking PEP ranged from 40-57% (165 overall). For those stopping at 3 days (source found to be negative) adherence was 139/140 (99%)and only 7 started PEP after 2 hours post exposure. However, adherence for a full month (source unknown) was only 6/12 (50%). If source HIV+ 10/15 (67%) took full course PEP. No occupational seroconversions occurred. Injury types will be presented. One source patient had undiagnosed HIV.
Conclusions:?1) HCW continue to have significant exposures despite universal precautions and training. 2) Compliance with full length PEP is poor. 3) Alternative PEP regimens that are simple and better tolerated are needed.

Presenting author:?J. Stephens,Mercer University S.O.M., 777 Hemlock Street, PO Box 6000-Hosp Box 79, Macon, GA 31208-6000, United States; Telephone +1 912 301 58 50; Fax +1 912 301 58 56; Email