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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

 

    

 

OCCUPATIONAL RISKS

By: Marble, Michelle, Blood Weekly, 10656073, 02/16/98-02/23/98
Database: Academic Search Premier

 

"Hepatitis C Virus and HIV Coinfection after Conjunctival Contamination with Blood." G. Ippolito, G. De Carli, V. Puro, N. Petrosillo, M. Rastrelli, G. Micheloni and L. Caggese. Coordinating Centre of the Italian Study on Occupational Risk of HIV infection (SIROH) at Centro di Riferimento AIDS IRCCS 'L. Spallanzani', Roma, Italy.

According to an abstract submitted by the authors to the 48th Annual Meeting of the American Association for the Study of Liver Diseases, held November 7-11, 1997 in Chicago, Illinois, "In the SIROH we previously observed a nurse who acquired HIV infection and developed acute nonA, nonB hepatitis (assays for anti-Hepatitis C Virus antibodies were at that time not available) via mucous membrane blood contamination. The nurse progressed to AIDS four years after and died within five years. More recently, another case of documented occupational HIV and Hepatitis C Virus simultaneous infection following blood contamination of conjunctive was observed in a housekeeper when disposing of open, HIV infected blood tubes. Zidovudine prophylaxis was administered three hours after exposure at 1000 mg/die for four weeks. Baseline anti-HIV and anti-Hepatitis C Virus tests were negative. An acute retroviral syndrome developed on day 29 post-exposure. Anti-HIV and anti-Hepatitis C Virus seroconversions were observed on day 53 and three months post-exposure, respectively. At four years of seroconversion, CD4(+) cells were 31/mmc, and the HCW developed full blown AIDS. Simultaneous HIV and Hepatitis C Virus infections can occur via conjunctival contamination with blood. This route of exposure should be considered at high risk for occupational transmission of bloodborne infections. Changes in work procedures and safety design of items should be implemented to minimize the risk of occupational exposure due to disposal of blood samples and to unprotected gaps of personal protective equipment. One-drug regimen with zidovudine should no longer be considered as antiretroviral postexposure prophylaxis. It could be postulated that the pathogenetic interactions between the two viruses during acute co-infection, that warrant further study, could have led to a rapid HIV disease progression. Supported by Italian Ministry of Health -- AIDS project."