Exposure to Human Immunodeficiency Disease. What Precautions for the Healthcare Professional?

Background: The Human Immunodeficiency Virus (HIV) epidemic is more pronounced in sub- Saharan Africa. The ever-increasing prevalence of HIV infection and the continued improvement in clinical management has increased the likelihood of these patients being managed by healthcare workers. The aim of the review was to assess current literature on the risks of transmission of HIV infection and protection of the healthcare worker. Methods: A literature review was performed using MEDLINE articles addressing ‘human immunodeficiency virus’, ‘HIV’, ‘Acquired immunodeficiency syndrome’, ‘AIDS’, ‘HIV and Surgery’. We also manually searched relevant surgical journals and completed the bibliographic compilation by collecting cross references from published papers. Results: Transmission is by contamination with body fluids for example needle-stick injury and blood splashes. The risk of HIV transmission from patient to healthcare worker always exists. The risk of transmission is very small and depends on the type of discipline and type of procedure. Hollow needles are more dangerous than suture needles. Sero-conversion is, however, very minimal. Universal precautions are emphasised. In case of needle-stick injury or splash it is important that affected healthcare workers take post-exposure prophylaxis. Conclusion: Occupational HIV transmission is lower than that for other infections. However, protection of all health care personnel should be the prime objective. Universal infection control guidelines must be accepted and strictly enforced. A prompt response to blood contact is crucial and post-exposure prophylaxis is essential