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A case-control study of HIV seroconversion in health care workers after percutaneous exposure. Centers for Disease Control and Prevention Needlestick Surveillance Group.
N Engl J Med. 1997 Nov 20; 337(21):1485-90.NEJM

Abstract

BACKGROUND

The average risk of human immunodeficiency virus (HIV) infection after percutaneous exposure to HIV-infected blood is 0.3 percent, but the factors that influence this risk are not well understood.

METHODS

We conducted a case-control study of health care workers with occupational, percutaneous exposure to HIV-infected blood. The case patients were those who became seropositive after exposure to HIV, as reported by national surveillance systems in France, Italy, the United Kingdom, and the United States. The controls were health care workers in a prospective surveillance project who were exposed to HIV but did not seroconvert.

RESULTS

Logistic-regression analysis based on 33 case patients and 665 controls showed that significant risk factors for seroconversion were deep injury (odds ratio= 15; 95 percent confidence interval, 6.0 to 41), injury with a device that was visibly contaminated with the source patient's blood (odds ratio= 6.2; 95 percent confidence interval, 2.2 to 21), a procedure involving a needle placed in the source patient's artery or vein (odds ratio=4.3; 95 percent confidence interval, 1.7 to 12), and exposure to a source patient who died of the acquired immunodeficiency syndrome within two months afterward (odds ratio=5.6; 95 percent confidence interval, 2.0 to 16). The case patients were significantly less likely than the controls to have taken zidovudine after the exposure (odds ratio=0.19; 95 percent confidence interval, 0.06 to 0.52).

CONCLUSIONS

The risk of HIV infection after percutaneous exposure increases with a larger volume of blood and, probably, a higher titer of HIV in the source patient's blood. Postexposure prophylaxis with zidovudine appears to be protective.

Authors+Show Affiliations

National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9366579

Citation

Cardo, D M., et al. "A Case-control Study of HIV Seroconversion in Health Care Workers After Percutaneous Exposure. Centers for Disease Control and Prevention Needlestick Surveillance Group." The New England Journal of Medicine, vol. 337, no. 21, 1997, pp. 1485-90.
Cardo DM, Culver DH, Ciesielski CA, et al. A case-control study of HIV seroconversion in health care workers after percutaneous exposure. Centers for Disease Control and Prevention Needlestick Surveillance Group. N Engl J Med. 1997;337(21):1485-90.
Cardo, D. M., Culver, D. H., Ciesielski, C. A., Srivastava, P. U., Marcus, R., Abiteboul, D., Heptonstall, J., Ippolito, G., Lot, F., McKibben, P. S., & Bell, D. M. (1997). A case-control study of HIV seroconversion in health care workers after percutaneous exposure. Centers for Disease Control and Prevention Needlestick Surveillance Group. The New England Journal of Medicine, 337(21), 1485-90.
Cardo DM, et al. A Case-control Study of HIV Seroconversion in Health Care Workers After Percutaneous Exposure. Centers for Disease Control and Prevention Needlestick Surveillance Group. N Engl J Med. 1997 Nov 20;337(21):1485-90. PubMed PMID: 9366579.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A case-control study of HIV seroconversion in health care workers after percutaneous exposure. Centers for Disease Control and Prevention Needlestick Surveillance Group. AU - Cardo,D M, AU - Culver,D H, AU - Ciesielski,C A, AU - Srivastava,P U, AU - Marcus,R, AU - Abiteboul,D, AU - Heptonstall,J, AU - Ippolito,G, AU - Lot,F, AU - McKibben,P S, AU - Bell,D M, PY - 1997/11/20/pubmed PY - 1997/11/20/medline PY - 1997/11/20/entrez SP - 1485 EP - 90 JF - The New England journal of medicine JO - N Engl J Med VL - 337 IS - 21 N2 - BACKGROUND: The average risk of human immunodeficiency virus (HIV) infection after percutaneous exposure to HIV-infected blood is 0.3 percent, but the factors that influence this risk are not well understood. METHODS: We conducted a case-control study of health care workers with occupational, percutaneous exposure to HIV-infected blood. The case patients were those who became seropositive after exposure to HIV, as reported by national surveillance systems in France, Italy, the United Kingdom, and the United States. The controls were health care workers in a prospective surveillance project who were exposed to HIV but did not seroconvert. RESULTS: Logistic-regression analysis based on 33 case patients and 665 controls showed that significant risk factors for seroconversion were deep injury (odds ratio= 15; 95 percent confidence interval, 6.0 to 41), injury with a device that was visibly contaminated with the source patient's blood (odds ratio= 6.2; 95 percent confidence interval, 2.2 to 21), a procedure involving a needle placed in the source patient's artery or vein (odds ratio=4.3; 95 percent confidence interval, 1.7 to 12), and exposure to a source patient who died of the acquired immunodeficiency syndrome within two months afterward (odds ratio=5.6; 95 percent confidence interval, 2.0 to 16). The case patients were significantly less likely than the controls to have taken zidovudine after the exposure (odds ratio=0.19; 95 percent confidence interval, 0.06 to 0.52). CONCLUSIONS: The risk of HIV infection after percutaneous exposure increases with a larger volume of blood and, probably, a higher titer of HIV in the source patient's blood. Postexposure prophylaxis with zidovudine appears to be protective. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/9366579/A_case_control_study_of_HIV_seroconversion_in_health_care_workers_after_percutaneous_exposure__Centers_for_Disease_Control_and_Prevention_Needlestick_Surveillance_Group_ L2 - https://www.nejm.org/doi/10.1056/NEJM199711203372101?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -