Kennedy I, Williams S
Occupational Health and Safety Unit, Royal Free Hampstead NHS Trust, London, UK.
Occup Med (Lond). 2000 Aug;50(6):387-91. doi: 10.1093/occmed/50.6.387.
Healthcare workers are at risk of occupationally acquired HIV infection primarily due to percutaneous exposure to HIV infected blood. The average risk of HIV transmission after such exposure is approximately 0.3%. There is evidence of higher risk for exposures involving an increased volume of blood (deep injury, injury with a device visibly contaminated with source patient's blood and a procedure which involved a needle placed in the source patient's artery or vein) and exposures to source patients with a high viral load. Triple therapy with two nucleoside analogues (zidovudine, lamivudine) and a protease inhibitor (indinavir) is now widely used for post-exposure prophylaxis following occupational exposure to HIV. Most of the evidence for the efficacy of prophylaxis is based on zidovudine monotherapy. Little is known about the long-term toxicity of these drugs in non-infected individuals. Their use in these circumstances requires careful assessment of possible risks and benefits.
医护人员面临职业性获得性艾滋病毒感染的风险，主要原因是经皮接触到感染艾滋病毒的血液。此类接触后艾滋病毒传播的平均风险约为0.3%。有证据表明，接触血量增加（深部损伤、使用明显被源患者血液污染的器械造成的损伤以及涉及将针头插入源患者动脉或静脉的操作）以及接触病毒载量高的源患者会导致更高的风险。目前，两种核苷类似物（齐多夫定、拉米夫定）和一种蛋白酶抑制剂（茚地那韦）的三联疗法被广泛用于职业性接触艾滋病毒后的暴露后预防。预防效果的大多数证据基于齐多夫定单药治疗。对于这些药物在未感染个体中的长期毒性知之甚少。在这些情况下使用这些药物需要仔细评估可能的风险和益处。
