Rampino R D, Rampino C D
Coney Island Hospital, Brooklyn, New York.
Clin Podiatr Med Surg. 1992 Oct;9(4):917-32.
This article discusses HIV transmission, prevention, and treatment in a hospital milieu. In a review of all the literature, minimal research has been done on correlating the potency of the virus in terms of transmission with the stage of the disease in an HIV-infected patient. It seems logical that the risk of transmission will increase when the HIV patient has the full blown disease. This might reflect the statistic that 5.3% of all the health care workers infected do not have a determinable cause. Yet it has been proven that seroconversion can occur after nonparenteral exposure. This is confirmed by a recent CDC update that reported seven cases of seroconversion from mucous membrane exposure. More extensive study is needed in developing more accurate statistics on the cumulative risk of health care workers in specific fields of medicine and specific patient communities. Because all the questions on AIDS apparently are not even close to being answered, the importance of using universal precautions cannot be overstressed. Unfortunately, research and experience have shown that compliance in adopting universal precautions is remarkably poor. Training and education must begin at the medical school level with reinforcement through yearly workshops. Prevention seems to be the only hope at this time. The physician's inability to test patients for this virus has only been a deterrent in learning about this dreadful epidemic.
本文讨论了医院环境中艾滋病毒的传播、预防和治疗。在对所有文献的回顾中，关于将艾滋病毒感染者疾病阶段与病毒传播效力相关联的研究极少。艾滋病毒感染者病情全面发作时传播风险会增加，这似乎合乎逻辑。这或许能解释5.3%的医护人员感染病例无明确感染源这一统计数据。然而，已有证据表明非肠道接触后也可能发生血清转化。美国疾病控制与预防中心（CDC）近期的一份报告证实了这一点，该报告称有7例因黏膜接触导致血清转化的病例。需要开展更广泛的研究，以得出关于特定医学领域和特定患者群体中医护人员累积风险的更准确统计数据。由于关于艾滋病的所有问题显然远未得到解答，因此强调普遍预防措施的重要性怎么都不为过。不幸的是，研究和经验表明，普遍预防措施的执行情况非常糟糕。培训和教育必须从医学院阶段开始，并通过年度研讨会加以强化。目前看来，预防似乎是唯一的希望。医生无法为患者检测这种病毒，这一直是了解这一可怕流行病的障碍。
