National Institutes of Health Clinical Center, Bethesda, MD 20892-1888, USA.
JAMA. 2012 Jan 4;307(1):75-84. doi: 10.1001/jama.2011.1828. Epub 2011 Dec 6.
Since its identification in 1985, human immunodeficiency virus (HIV) has challenged several aspects of health care delivery. Because HIV is a blood-borne infectious disease, from the early days of the epidemic, concern was raised about risks of occupational exposures and infections among health care workers. Despite the development of highly active antiretroviral therapy, which has effectively modulated HIV into a chronic disease in many settings, risks of occupational infection with 3 blood-borne pathogens remain in the health care workplace. Using the case of a house officer who has a needlestick during a resuscitation attempt, prevention of needlesticks including universal precautions and postexposure management of occupational HIV, hepatitis B, and hepatitis C exposures is discussed.
自 1985 年发现以来,人类免疫缺陷病毒(HIV)对医疗服务的多个方面提出了挑战。由于 HIV 是一种血液传播的传染病,因此从疫情早期开始,就有人担心医护人员在工作中面临职业暴露和感染的风险。尽管高效抗逆转录病毒疗法的发展已在许多情况下将 HIV 有效地控制为慢性病,但医护工作场所仍存在感染 3 种血源性病原体的职业感染风险。本文通过一位住院医师在复苏尝试中发生针刺伤的案例,讨论了包括普遍预防措施和职业暴露后 HIV、乙型肝炎和丙型肝炎暴露的管理在内的针刺伤预防措施。