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Transmission of Drug-Resistant HIV After an Occupational Exposure Despite Postexposure Prophylaxis With a Combination Drug Regimen

Published online by Cambridge University Press:  02 January 2015

Elise M. Beltrami*
Affiliation:
Prevention and Evaluation Branch, Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Chi-Cheng Luo
Affiliation:
HIV Immunology and Diagnostics Branch, Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Nicolas de la Torre
Affiliation:
HIV Immunology and Diagnostics Branch, Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Denise M. Cardo
Affiliation:
Prevention and Evaluation Branch, Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Centers for Disease Control and Prevention, Mailstop E-68, 1600 Clifton Road, Atlanta, GA30333

Abstract

We documented a case of occupational human immunodeficiency virus (HIV) despite postexposure prophylaxis (PEP) with a combination drug regimen after percutaneous injury with a needle from a sharps disposal container in the hospital room of an HIV-infected patient. This failure of PEP with a combination drug regimen may have been related to antiretroviral drug resistance, other factors, or both. This case highlights the importance of preventing injury to prevent occupational transmission of HIV.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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References

1.Centers for Disease Control and Prevention. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR 2001;50(RR-11):152.Google Scholar
2.Cardo, DM, Culver, DH, Ciesielski, CA, et al. A case-control study of HIV seroconversion in health care workers after percutaneous exposure. N Engl J Med 1997;337:14851490.CrossRefGoogle ScholarPubMed
3.Black, RJ. Animal studies of prophylaxis. Am J Med 1997;102(suppl 5B):3944.Google Scholar
4.Connor, EM, Sperling, RS, Gelber, R, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Engl J Med 1994;331:11731180.CrossRefGoogle ScholarPubMed
5.Tokars, JI, Marcus, R, Culver, DH, et al. Surveillance of HIV infection and zidovudine use among health care workers after occupational exposure to HIV-infected blood. Ann Intern Med 1993;118:913919.Google Scholar
6.Jochimsen, EM. Failures of zidovudine postexposure prophylaxis. Am J Med 1997;102(5B):5255.CrossRefGoogle ScholarPubMed
7.Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, vol. 12, no. 1. Atlanta, GA: Centers for Disease Control and Prevention; 2000:24.Google Scholar
8.Perdue, B, Wolderufael, D, Mellors, J, et al. HIV-1 transmission by a needlestick injury despite rapid initiation of four-drug postexposure prophylaxis. Presented at the 6th Conference on Retroviruses and Opportunistic Infections; January 31-February 4, 1999; Chicago, IL. Abstract 210.Google Scholar
9.Lot, F, Abiteboul, D. Occupational HIV infection in France. Presented at the 4th International Conference on Occupational Health for Health Care Workers; September 28-October 1, 1999; Montreal, Quebec, Canada. Abstract WP-25.Google Scholar
10.Hirsch, MS, Brun-Vézinet, F, D'Aquila, RT, et al. Antiretroviral drug resistance testing in adult HIV-1 infection: recommendations of an international AIDS Society-USA panel. JAMA 2000;283:24172426.CrossRefGoogle ScholarPubMed
11.Devereux, HL, Youle, M, Johnson, MA, Loveday, C. Rapid decline in detectability of HIV-1 drug resistance mutations after stopping therapy. AIDS 1999;13:F123F127.CrossRefGoogle ScholarPubMed
12.Centers for Disease Control and Prevention. Serious adverse events attributed to nevirapine regimens for postexposure prophylaxis after HIV exposures worldwide, 1997-2000. MMWR 2001;49:11531156.Google Scholar
13.Bylund, DJ, Ziegner, UH, Hooper, DG. Review of testing for human immunodeficiency virus. Clin Lab Med 1992;12:305333.CrossRefGoogle ScholarPubMed
14.Simonsen, L, Buffington, J, Shapiro, CN, et al. Multiple false reactions in viral antibody screening assays after influenza vaccination. Am J Epidemiol 1995;141:10891096.CrossRefGoogle ScholarPubMed
15.Hsia, J. False-positive ELISA for human immunodeficiency virus after influenza vaccine. J Infect Dis 1993;167:989990. Letter.CrossRefGoogle Scholar