AIDS in the workplace

AH Mehrparvar,MDOccupational Medicine departmentYazd University of Medical Sciences

Introduction Human Immunodeficiency Virus A retrovirus HIV-1 and HIV-2 RNA and reverse transcriptase Enters cells expressing CD4 (a group of T

lymphocytes)

Transmission of HIV HIV isolated from:

Blood Semen Vaginal secretion Breast milk and:

Saliva Tear urine

75% of all HIV infections are due to sexual intercourse

Blood and blood products Maternal-infant

Diagnostic tests Screening

Ab against HIV (4-12 weeks later) False positive: multiple pregnancies,

transfusion, autoimmune diseases Confirmatory

Western blot: negative, indeterminate, positive Virologic markers

Pathogenesis Acute or primary infection

Fever, fatigue, pharyngitis, LAP, myalgia, rash Asymptomatic phase

7-10 years Symptomatic phase

CD4<200/mm3

Opportunistic infections: Fungal infections Herpes simplex TB

Occupational risk of HIV Directly proportional to the risk of

exposure to HIV-infected blood Jobs: HCWs Military personnel Safety/rescue personnel sporstmen

HCWs Most common: needlestick RR of percutaneous infection: 1 in 300 Influencing factors:

Quantity and depth of infection Visible blood on needle Terminal AIDS

Other exposures: Intact skin with large quantities of blood Mucous membrane exposure

Primary prevention Minimizing contact with moist body

substances and surfaces, by: Handwashing

With warm water and plain soap Antimicrobila agents are not necessary

Gloves Gowns Face shields

Primary prevention Do not recap needles Put disposable syringe, needle and other

sharp devices in puncture-resistant containers

Put containers as close as possible to use areas

Clean-up spills of blood or other body fluids with suitable germicide

Dispose of gloves last Wash the hand after disposing gloves

Secondary prevention After needlestick: Cleanse wounds If source seronegative:

Baseline test and follow-up 12 weeks later If source unknown or positive:

Chemoprophylaxis Zidovudine during 72 hours after exposure

Baseline test ant follow-up at 6, 12, and 26 weeks

Sportsmen Do not recommend routine testing Do not restrict HIV-positive athletes from

playing

Military personnel They may not serve in combat units They may not be assigned remote from

medical centers

Mortuary workers HIV in blood up to 21 hours after death HIV in bone, brain and viscera after 2

weeks