This Article  • References  • Full text PDF  • Correction  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Association With Needle-Stick Injuries

Stanley H. Weiss, MD; W. Carl Saxinger, PhD; David Rechtman, MD; Michael H. Grieco, MD; Jeffrey Nadler, MD; Susan Holman, RN, MS; Harold M. Ginzburg, MD; Jerome E. Groopman, MD; James J. Goedert, MD; Phillip D. Markham, PhD; Robert C. Gallo, MD; William A. Blattner, MD; Sheldon Landesman, MD

JAMA. 1985;254(15):2089-2093.

Abstract
Health care workers are caring for an increasing number of persons infected with human T-cell lymphotropic virus type III (HTLV-III), the primary etiologic agent of the acquired immunodeficiency syndrome (AIDS). We studied 361 health care and clinical laboratory personnel from institutions in several metropolitan areas with both high and moderate levels of HTLV-III infection among high-risk group members to evaluate routes of exposure to and seropositivity for HTLV-III. Protection of the privacy of subjects and prospective determination of risk factors were integral components of the study design. Six (26%) of 23 health care workers with recognized risk factors for AIDS had HTLV-III antibodies. Thirty-nine (14%) of 278 workers at one institution as well as a total of five workers from other institutions reported possible percutaneous exposure to HTLV-III, usually injuries with needles that had been used on AIDS patients. There were three HTLV-III seropositive subjects who reported possible parenteral exposure to HTLV-III but no recognized AIDS risk factors. One was a symptomatic female, subject A, and her apparent sources of HTLV-III exposure were two puncture wounds, without injection of blood, made with needles used on AIDS patients. Human T-cell lymphotropic virus type III was cultured from her asymptomatic, seronegative long-term sexual partner, apparently representing female-to-male transmission. For the two other seropositive workers (subjects B and C) with nosocomial parenteral exposure, we could not rule out heterosexual transmission as a possible source of HTLV-III exposure. These latter two cases as well as the identification of seropositive health care providers from known risk groups point to the need for thorough case investigation to identify routes of exposure in health care workers. The risk of nosocomial HTLV-III transmission appears to be low and related to percutaneous exposure. Medical personnel should be trained systematically in the proper techniques and handling of instruments for phlebotomy and similar procedures to decrease occupational exposure to HTLV-III.

(JAMA 1985;254:2089-2093)

Author Affiliations
From the Environmental Epidemiology Branch (Drs Weiss, Goedert, and Blattner) and the Laboratory of Tumor Cell Biology (Drs Saxinger, Markham, and Gallo), National Cancer Institute, Bethesda, Md; the National Institute on Drug Abuse, Rockville, Md (Dr Ginzburg); Downstate Medical Center, Brooklyn, NY (Drs Rechtman, Nadler, and Landesman and Ms Holman); St Luke's-Roosevelt Hospital Center, New York (Dr Grieco); and New England Deaconess Hospital, Boston (Dr Groopman).

Footnotes
Reprint requests to Environmental Epidemiology Branch, National Cancer Institute, Landow Bldg, Room 3C29, Bethesda, MD 20205 (Dr Weiss).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Postexposure Chemoprophylaxis for Occupational Exposures to the Human Immunodeficiency Virus
Henderson
JAMA 1999;281:931-936.
FULL TEXT  

Prevalence of Viremia in Human Immunodeficiency Virus-Infected Patients With Renal Disease
Kimmel et al.
Arch Intern Med 1995;155:1578-1584.
ABSTRACT  

Risk of Needlesticks and Occupational Exposures Among Residents and Medical Students
O'Neill et al.
Arch Intern Med 1992;152:1451-1456.
ABSTRACT  

Percutaneous Injuries During Operation: Who Is at Risk for What?
Nichols
JAMA 1992;267:2938-2939.
ABSTRACT  

Are Universal Precautions Effective in Reducing the Number of Occupational Exposures Among Health Care Workers? A Prospective Study of Physicians on a Medical Service
Wong et al.
JAMA 1991;265:1123-1128.
ABSTRACT  

Human Immunodeficiency Virus Infection in Health Care Workers: A Method for Estimating Individual Occupational Risk
Hagen et al.
Arch Intern Med 1989;149:1541-1544.
ABSTRACT  

Cardiopulmonary Resuscitation in Patients With the Acquired Immunodeficiency Syndrome: A Prospective Study
Raviglione et al.
Arch Intern Med 1988;148:2602-2605.
ABSTRACT  

Prostatic Cancer in a Patient with Asymptomatic HIV Infection: Are Some Liues More Equal than Others ?
Roach et al.
Med Decis Making 1988;8:132-144.
 

AIDS and HIV Update: Acquired Immunodeficiency Syndrome and Human Immunodeficiency Virus Infection Among Health-Care Workers
JAMA 1988;259:2817-2821.
 

Routine Preoperative Screening for HIV: Does the Risk to the Surgeon Outweigh the Risk to the Patient?
Hagen et al.
JAMA 1988;259:1357-1359.
ABSTRACT  

Human Immunodeficiency Virus Infection and the Acquired Immune Deficiency Syndrome: A Review
Schechter and Coates
Sex Abuse 1988;1:205-225.
ABSTRACT  

Prevalence of Antibody to Human Immunodeficiency Virus and Hepatitis B Surface Antigen in Blood Samples Submitted to a Hospital Laboratory: Implications for Handling Specimens
Handsfield et al.
JAMA 1987;258:3395-3397.
ABSTRACT  

Physicians, AIDS, and Occupational Risk: Historic Traditions and Ethical Obligations
Zuger and Miles
JAMA 1987;258:1924-1928.
ABSTRACT  

Unsuspected Human Immunodeficiency Virus in Critically III Emergency Patients
Baker et al.
JAMA 1987;257:2609-2611.
ABSTRACT  

Recovery of Human Immunodeficiency Virus From Serum
Michaelis and Levy
JAMA 1987;257:1327-1327.
ABSTRACT  

National Surveillance of AIDS in Health Care Workers
Lifson et al.
JAMA 1986;256:3231-3234.
ABSTRACT  

HIV Seroprevalence Among Hospital Workers in Kinshasa, Zaire: Lack of Association With Occupational Exposure
Mann et al.
JAMA 1986;256:3099-3102.
ABSTRACT  

Infection with Human Immunodeficiency Virus in the Hospital: Epidemiology, Infection Control, and Biosafety Considerations
CONTE
ANN INTERN MED 1986;105:730-736.
ABSTRACT  

Lack of Antibodies to HTLV-III/LAV in Danish Dentists
Ebbesen et al.
JAMA 1986;256:2199-2199.
ABSTRACT  

Leads from the MMWR
JAMA 1986;256:1857-1873.
 

How to Keep Up with the Medical Literature: IV. Using the Literature to Solve Clinical Problems
HAYNES et al.
ANN INTERN MED 1986;105:636-640.
ABSTRACT  

Laboratory and Epidemiologic Evaluation of an Enzyme Immunoassay for Antibodies to HTLV-III
Ward et al.
JAMA 1986;256:357-361.
ABSTRACT  

Risk of Nosocomial Infection with Human T-Cell Lymphotropic Virus Type III/Lymphadenopathy-Associated Virus in a Large Cohort of Intensively Exposed Health Care Workers
HENDERSON et al.
ANN INTERN MED 1986;104:644-647.
ABSTRACT  

HTLV-III/LAV-Seronegative, Virus-Negative Sexual Partners and Household Contacts of Hemophiliacs
McFadden et al.
JAMA 1986;255:1702-1702.
ABSTRACT  

Acquired Immunodeficiency Syndrome
ANN INTERN MED 1986;104:575-581.
ABSTRACT  

Leads from the MMWR
JAMA 1986;255:1005-1013.
 

AIDS, Social Sciences, and Health Education: A Personal Perspective
Osborn
Health Educ Behav 1986;13:287-299.
 

Leads from the MMWR
JAMA 1985;254:3023-3026.
 

HTLV-III Transmission
Grouse
JAMA 1985;254:2130-2131.
ABSTRACT