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To the Editor: Health care workers (HCWs) are a group at significant risk for human immunodeficiency virus (HIV) infection through occupational exposure.¹ Guidelines from the US Public Health Service on the management of occupational exposure to HIV recommend antiretroviral postexposure prophylaxis for HCWs with occupational exposure associated with a risk for HIV transmission.² The recommended regimen includes zidovudine and lamivudine, with or without indinavir or nelfinavir, depending on the type of exposure. The guidelines also include management of occupational exposure with suspected drug-resistant HIV. Alternative regimens are not specified, but should be based on the likelihood that the source patient's HIV isolate will be susceptible to the postexposure prophylaxis. Limited data exist on the prevalence of mutations conferring antiretroviral resistance in HIV isolates from patients involved in HCW occupational exposure.² To address this issue, we evaluated source patient HIV isolates for antiretroviral resistance mutations.

Methods.

Twenty-two patients infected with HIV (1993-1996) . . . [Full Text of this Article]

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Proc. Natl. Acad. Sci. USA 1999;96:10367-10372.
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