Howard R J
Department of Surgery, J. Hillis Miller Health Science Center, University of Florida, Gainesville 32610.
Surg Gynecol Obstet. 1990 Jul;171(1):22-6.
Physicians and other health care workers risk infection with human immunodeficiency virus (HIV), hepatitis B virus and other infectious agents. Most authorities have argued against routine testing of patients preoperatively for HIV infection because it would not prevent or reduce the risk of infection to health care workers. They agree with the policy of the Centers for Disease Control that advocates universal precautions for all patients. Surgeons have not been reassured by these arguments. They claim that their exposure to blood during operation exposes them to increased risk of infection. The risk of acquiring HIV from a single needle-stick injury is low. However, most surgeons are interested in their lifetime risk of infection. In this study, a mathematical model for predicting the risk of acquiring HIV in patients in a given hospital and the total number of needle-stick injuries are given. Using minimal likely HIV seroprevalence, this model predicts that at least 47 of the approximately 18,000 Fellows of the American College of Surgeons would become infected. New data showing early treatment can lead to increased longevity in infected patients with HIV, the fact that many health care workers do not follow universal precautions and other arguments are put forward to support a suggested routine--voluntary testing of all surgical patients for antibody to HIV.
医生和其他医护人员面临感染人类免疫缺陷病毒（HIV）、乙型肝炎病毒及其他感染源的风险。大多数权威人士反对术前对患者进行常规HIV感染检测，因为这无法预防或降低医护人员的感染风险。他们认同疾病控制中心倡导的对所有患者采取普遍预防措施的政策。然而，外科医生对这些观点并不放心。他们声称，手术过程中接触血液使他们面临更高的感染风险。单次针刺伤感染HIV的风险较低。不过，大多数外科医生关心的是他们一生的感染风险。在本研究中，给出了一个预测特定医院患者感染HIV风险以及针刺伤总数的数学模型。使用最低可能的HIV血清流行率，该模型预测，在美国外科医师学会约18000名会员中，至少有47人会被感染。新的数据表明早期治疗可延长HIV感染患者的寿命，许多医护人员未遵循普遍预防措施这一事实，以及其他一些观点被提出来支持一项建议，即对所有外科患者进行HIV抗体的常规——自愿检测。
