Occupational exposure to human immunodeficiency virus in hospital health care workers in Spain

Abstract

Background Human immunodeficiency virus (HIV) is an occupational risk in health workers exposed to HIVpositive blood. In the present study prospective surveillance of all cases of occupational exposure to HIV among health workers in a large Spanish hospital was performed over a 4-year period. Methods We performed a prospective epidemiological study of all cases of occupational exposure to HIV infection from July 1998 to June 2002. Details on the source patient and exposed health worker, as well as place and time of exposure, were gathered. Serologic HIV tests were carried out at baseline and at 1, 3, 6 and 12 months. Results A total of 75 occupational exposures were reported; 48% were in the group aged 26-35 years old and 75% were women. The attack rate was 4.6 cases per 1,000 persons/ year. Nurses reported 43% of accidents, followed by interns and resident physicians (28%). Most accidents (67%) occurred in the morning shift and 36% in a surgical setting. Post-exposure prophylaxis (PEP) was recommended in 71% of exposed subjects and 90% completed the 4-week PEP program. Eighty-nine percent and 57% attended the month 1 and month 6 serologic follow-up visits, respectively. No case of documented seroconversion was reported. Conclusions Health care workers, regardless of job category or healthcare setting, face a real risk of occupational exposure to HIV infection. These health professionals must continue to be educated about the risk of acquiring infections, ways of effectively reducing risks, and the benefit of timely reporting of occupational exposures.