aids in the workplace ah mehrparvar,md occupational medicine department yazd university of medical...
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AIDS in the workplace
AH Mehrparvar,MDOccupational Medicine departmentYazd University of Medical Sciences
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Introduction Human Immunodeficiency Virus A retrovirus HIV-1 and HIV-2 RNA and reverse transcriptase Enters cells expressing CD4 (a group of T
lymphocytes)
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Transmission of HIV HIV isolated from:
Blood Semen Vaginal secretion Breast milk and:
Saliva Tear urine
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75% of all HIV infections are due to sexual intercourse
Blood and blood products Maternal-infant
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Diagnostic tests Screening
Ab against HIV (4-12 weeks later) False positive: multiple pregnancies,
transfusion, autoimmune diseases Confirmatory
Western blot: negative, indeterminate, positive Virologic markers
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Pathogenesis Acute or primary infection
Fever, fatigue, pharyngitis, LAP, myalgia, rash Asymptomatic phase
7-10 years Symptomatic phase
CD4<200/mm3
Opportunistic infections: Fungal infections Herpes simplex TB
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Occupational risk of HIV Directly proportional to the risk of
exposure to HIV-infected blood Jobs: HCWs Military personnel Safety/rescue personnel sporstmen
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HCWs Most common: needlestick RR of percutaneous infection: 1 in 300 Influencing factors:
Quantity and depth of infection Visible blood on needle Terminal AIDS
Other exposures: Intact skin with large quantities of blood Mucous membrane exposure
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Primary prevention Minimizing contact with moist body
substances and surfaces, by: Handwashing
With warm water and plain soap Antimicrobila agents are not necessary
Gloves Gowns Face shields
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Primary prevention Do not recap needles Put disposable syringe, needle and other
sharp devices in puncture-resistant containers
Put containers as close as possible to use areas
Clean-up spills of blood or other body fluids with suitable germicide
Dispose of gloves last Wash the hand after disposing gloves
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Secondary prevention After needlestick: Cleanse wounds If source seronegative:
Baseline test and follow-up 12 weeks later If source unknown or positive:
Chemoprophylaxis Zidovudine during 72 hours after exposure
Baseline test ant follow-up at 6, 12, and 26 weeks
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Sportsmen Do not recommend routine testing Do not restrict HIV-positive athletes from
playing
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Military personnel They may not serve in combat units They may not be assigned remote from
medical centers
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Mortuary workers HIV in blood up to 21 hours after death HIV in bone, brain and viscera after 2
weeks