5th International AIDS Conference Montreal, Quebec, Canada — Jun 4-9, 1989

Int Conf AIDS 1989 Jun 4-9; 5:161 (abstract no. A.503)
Rastrelli M, Ferrazzi D, Vigo B, Giannelli F; Niguarda Ca Granda Hospital, Milan, Italy

OBJECTIVE: To assess the risk of nosocomial transmission of HIV in comparison with viral hepatitides and record the effects of adopting further protective and educational means.

METHODS: During the period June 1986-December 1988, all health care workers accidentally exposed to HIV in hospital had entered the study and been evaluated clinically and serologically for evidence of infection at time 0, 45, 90, 180, 360 days after exposure. All subjects exposed to viral hepatitides who were not vaccinated against HB and refused serum treatment were submitted to follow up.

RESULTS: 102 subjects had an accidental exposure (needlestick injuries 81; cuts with sharp instruments 12; splashes on mucous membranes 7; splashes on cutaneous wound 3). They represented all occupational categories (nurses 72, physicians 21, midwives 4, others 5). None of them was HIV-positive at basal assay. No seroconversion at ELISA was observed at the follow up (89 patients yet controlled at 6 months). An important decrease of the rate of new accidents occurred after adoption of more protective means since June 1988 (e.g. "Hands off" needles, new masks and glasses) and up to date revision of nursing guidelines: 13 cases versus 24,26,30, in the preceding half-year periods. 21 not vaccinated subjects suffered accidents with viral hepatitides contaminated materials and refused to be treated with specific Ig: 6 developed the disease (4 type B, 2 NANB hepatitides).

CONCLUSIONS: An important group of health care workers exposed to HIV has not shown evidence of infection whereas the risk of accidental transmission of viral hepatitides is far higher. Even if usual infection control guidelines in assisting HIV infected patients are sufficient to avoid viral transmission, the largest part of exposures (needlestick injuries and splashes) can be prevented using adequate nursing precautions and protective means.

890604
A503

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