Thompson Sandra C, Boughton Clem R, Dore Gregory J
Sexual Health and Blood-borne Virus Program, Communicable Diseases Control Branch, Department of Health, Perth, Western Australia.
Aust N Z J Public Health. 2003 Dec;27(6):602-7. doi: 10.1111/j.1467-842x.2003.tb00606.x.
More than 30 million needle syringes are distributed per year in Australia as a component of harm-reduction strategies for injecting drug users (IDU). Discarded needle syringes create considerable anxiety within the community, but the extent of needlestick injuries and level of blood-borne virus transmission risk is unclear. We have undertaken a review of studies of blood-borne virus survival as the basis for advice and management of community needlestick injuries.
A Medline review of published articles on blood-borne virus survival and outcome from community injuries.
Hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) can all survive outside the human body for several weeks, with virus survival influenced by virus titer, volume of blood, ambient temperature, exposure to sunlight and humidity. HBV has the highest virus titers in untreated individuals and is viable for the most prolonged periods in needle syringes stored at room temperature. However, prevalence of HBV and HIV are only 1-2% within the Australian IDU population. In contrast, prevalence of HCV is 50-60% among Australian IDUs and virus survival in needle syringes has been documented for prolonged periods. There have been no published cases of blood-borne virus transmission following community needlestick injury in Australia.
The risk of blood-borne virus transmission from syringes discarded in community settings appears to be very low. Despite this, procedures to systematically follow up individuals following significant needlestick exposures sustained in the community setting should be developed.
在澳大利亚，作为针对注射吸毒者（IDU）的减少伤害策略的一部分，每年分发超过3000万个针头注射器。废弃的针头注射器在社区内引发了相当大的焦虑，但针刺伤的程度以及血源病毒传播风险水平尚不清楚。我们对血源病毒存活情况的研究进行了综述，以此作为社区针刺伤建议和管理的依据。
对发表的关于血源病毒存活及社区伤害结果的文章进行医学文献数据库（Medline）检索。
乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）都能在人体外存活数周，病毒存活受病毒滴度、血量、环境温度、阳光照射和湿度影响。未经治疗的个体中HBV病毒滴度最高，在室温下储存的针头注射器中存活时间最长。然而，澳大利亚注射吸毒者人群中HBV和HIV的感染率仅为1%-2%。相比之下，澳大利亚注射吸毒者中HCV的感染率为50%-60%，并且已记录到针头注射器中病毒能长期存活。在澳大利亚，尚无社区针刺伤后血源病毒传播的公开病例。
社区环境中丢弃的注射器传播血源病毒的风险似乎非常低。尽管如此，仍应制定程序，对在社区环境中遭受重大针刺暴露的个体进行系统随访。
