Risk of Nosocomial Infection with Human T-Cell Lymphotropic Virus Type III/Lymphadenopathy-Associated Virus in a Large Cohort of Intensively Exposed Health Care Workers

doi:10.1059/0003-4819-104-5-644

Risk of Nosocomial Infection with Human T-Cell Lymphotropic Virus Type III/Lymphadenopathy-Associated Virus in a Large Cohort of Intensively Exposed Health Care Workers

DAVID K. HENDERSON, M.D.;
ALFRED J. SAAH, M.D., M.P.H.;
BARBARA J. ZAK, B.S.N.;
RICHARD A. KASLOW, M.D., M.P.H.;
H. CLIFFORD LANE, M.D.;
THOMAS FOLKS, Ph.D.;
WILLIAM C. BLACKWELDER, Ph.D.;
JAMES SCHMITT, M.D.;
DEBORAH J. LaCAMERA, B.S.N.;
HENRY MASUR, M.D.; and
ANTHONY S. FAUCI, M.D.

Bethesda, Maryland

Abstract

To assess the risk of nosocomial transmission of human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV), we prospectively evaluated a cohort of 531 health care workers. One hundred fifty of these employees reported percutaneous or mucous membrane exposures to blood or body fluids from a patient with the acquired immunodeficiency syndrome (AIDS) during the treatment of 238 such patients since 1981. None of these 150 employees had serologic evidence of HTLV-III/LAV infection on follow-up from 6 to 46 months after exposure. Of the 150, 46 were studied immunologically and 29 had lymphocytes cultured for HTLV-III/LAV. Results of all studies were normal. Of the 531 employees, 3 (0.56%) had serologic evidence of HTLV-III/LAV infection. All were seropositive at the time of study entry; none reported adverse nosocomial exposures. All acknowledged membership in one or more established risk groups for AIDS. This study provides strong evidence that the risk of nosocomial transmission of HTLV-III/LAV is extremely low.

Article and Author Information

▸From the Hospital Epidemiology Service and Critical Care Medicine Service, Clinical Center; the Laboratory of Clinical Investigation, Laboratory of Immunoregulation, Office of the Director, and Epidemiology and Biometry Section, Microbiology and Infectious Disease Program, National Institute of Allergy and Infectious Disease; and the Occupational Medical Service, Office of Research Services, Office of the Director, National Institutes of Health; Bethesda, Maryland.
▸Requests for reprints should be addressed to David K. Henderson, M.D.; Hospital Epidemiology Service, Clinical Center, National Institutes of Health, Building 10, Room 11N223, 9000 Rockville Pike; Bethesda, MD 20892.