Prevention of HIV Transmission: Hearings Before the Subcommittee on Health and the Environment of the Committee on Energy and Commerce, House of Representatives, One Hundred Second Congress, First Session, on Centers for Disease Control Guidelines for Health Professionals on the Prevention of Transmission of HIV During Exposure-prone Invasive Procedures, September 19 and 26, 1991, Volume 4U.S. Government Printing Office, 1992 - 384 pages |
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Address AIDS American AOUN Association blood bloodborne diseases body fluids Brentwood CDC guidelines Centereach Centers for Disease Chairman clinical Congress DANNEMEYER dental procedures dentist Disease Control doctors epidemic exposure exposure-prone procedures Farmingville FASSBINDER gloves going HCWs health care setting health care workers health-care hemophiliacs Henry Nicols hepatitis B virus Hepatitus HIV infection HIV positive HIV status HIV testing HIV transmission Holbrook hospital human immunodeficiency virus infected health infected with HIV infection control infection control procedures issue Kimberly Bergalis Koop Kuvin Lake Lake Grove mandatory testing MMWR needle Nesconset nurse percent physicians practice protect public health risk of HIV risk of transmission Ronk Ronkonkoma ROPER ROZAR Smithtown statement subcommittee surgeon surgery surgical tested for HIV testing Hir testing of health Thank tients tion transmission of HIV transmitted treat treatment universal precautions WAXMAN
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Page 121 - Perrillo RP, Schiff ER, Davis GL, et al. A randomized, controlled trial of interferon alfa-2b alone and after prednisone withdrawal for the treatment of chronic hepatitis B. N Engl J Med 1990:323:295-301.
Page 119 - The public health benefit of notification of patients who have had exposureprone procedures performed by HCWs infected with HIV or positive for HBeAg should be considered on a case-by-case basis, taking into consideration an assessment of specific risks, confidentiality issues, and available resources. Carefully designed and implemented follow-up studies are necessary to determine more precisely the risk of transmission during such procedures. Decisions regarding notification and follow-up studies...
Page 121 - Educ 1991:55:187-91. 42. Mishu B, Schaffner W, Horan JM, Wood LH, Hutcheson R, McNabb P. A surgeon with AIDS: lack of evidence of transmission to patients. JAMA 1990:264:467-70. 43. Tokars J, Bell D, Marcus R, et al. Percutaneous injuries during surgical procedures [Abstract]. VII International Conference on AIDS. Vol 2. Florence, Italy, June 16-21, 1991:83. 44. Perrillo RP, Schiff ER, Davis GL, et al. A randomized, controlled trial of interferon...
Page 116 - ... HBV (6, 22-29). Transmission of HIV During Invasive Procedures The risk of HIV transmission to an HCW after percutaneous exposure to HIVinfected blood is considerably lower than the risk of HBV transmission after percutaneous exposure to HBeAg-positive blood (0.3% versus approximately 30%) (33-35). Thus, the risk of transmission of HIV from an infected HCW to a patient during an invasive procedure is likely to be proportionately lower than the risk of HBV transmission from an HBeAg-positive HCW...
Page 118 - Health-care workers who have exudative lesions or weeping dermatitis should refrain from all direct patient care and from handling patient-care equipment until the condition resolves.
Page 242 - Equipment and devices that touch intact mucous membranes but do not penetrate the patient's body surfaces should be sterilized when possible or undergo high-level disinfection if they cannot be sterilized before being used for each patient.
Page 120 - Med 1982:96:119. 16. Ahtone J, Goodman RA. Hepatitis B and dental personnel: transmission to patients and prevention issues. J Am Dent Assoc 1983;106:219-22. 17. Shaw FE, Jr. Barrett CL, Hamm R, et al. Lethal outbreak of hepatitis B in a dental practice. JAMA 1986;255:3260-4. 18. CDC. Outbreak of hepatitis B associated with an oral surgeon. New Hampshire. MMWR 1987;36:132-3.
Page 118 - Previous recommendations have specified that infection-control programs should incorporate principles of universal precautions (ie, appropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments) and should maintain these precautions rigorously in all health-care settings (1,2,5).
Page 116 - ... 24). For five HCWs, no further transmission to patients was observed. In two instances involving an obstetrician/gynecologist and an oral surgeon, HBV was transmitted to patients after techniques were modified (6, 12). Review of the 20 published studies indicates that a combination of risk factors accounted for transmission of HBV from HCWs to patients. Of the HCWs whose hepatitis B e antigen (HBeAg) status was determined (17 of 20), all were HBeAg positive. The presence of HBeAg in serum is...
Page 121 - Porter JD, Cruikshank JG, Gentle PH, Robinson RG, Gill ON. Management of patients treated by a surgeon with HIV infection. [Letter] Lancet 1990:335:113-4.