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Cited by 1,198HIV/AIDS Research and InterventionsInfection Control in HealthcareHIV Research and Treatment

A case-control study of HIV seroconversion in health care workers after percutaneous exposure.

Cardo, Denise M., Culver, David H., Ciesielski, Carol A., Srivastava, Pamela U., Marcus, Ruthanne, Abiteboul, Dominique, Heptonstall, Julia, Ippolito, Giuseppe +3 more·1997·New England Journal of Medicine
DOI 10.1056/nejm199711203372101
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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.

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Crossref · 10.1056/nejm199711203372101

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  • PEP with a 28-day course of zidovudine was associated with an 81% reduction in risk for acquiring HIV in a study of health care workers who had percutaneous exposures to HIV-infected blood.

    “PEP with a 28-day course of zidovudine was associated with an 81% reduction in risk for acquiring HIV in a study of health care workers who had percutaneous exposures to HIV-infected blood (1430).”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1430]

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Authors
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.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • National Center for Infectious Diseases (US)
  • Institut National de Recherche et de Sécurité (FR)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1997-11-20
Volume
337
Issue
21
Pages
1485-1490
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199711203372101
OpenAlex
W2329960468
Cited by
1,198
References
18
Citations by year
2026: 14 · 2025: 26 · 2024: 26 · 2023: 22 · 2022: 38 · 2021: 19 · 2020: 28 · 2019: 32 · 2018: 30 · 2017: 30 · 2016: 48 · 2015: 53 · 2014: 52 · 2013: 45 · 2012: 54
FWCI
32.55
Type
journal article
Language
en
Open access
closed
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
  • Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
Keywords
HIV seroconversion, occupational exposure, healthcare workers, percutaneous exposure, needlestick injuries, risk factors, zidovudine, post-exposure prophylaxis, blood volume
MeSH terms
Analysis of Variance, Female, Health Personnel, HIV Seropositivity, Humans, Male, Occupational Diseases, Population Surveillance, Risk Factors, Wounds, Stab, Zidovudine, HIV Infections, Logistic Models, Case-Control Studies, Needlestick Injuries, Infectious Disease Transmission, Patient-to-Professional, Blood-Borne Pathogens, Anti-HIV Agents

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