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| Titel: |
Passive Transfer of HIV-1 Antibodies and Drug Resistant Virus during a Health Care Worker Accident: Implications for HCW Post-Exposure Management |
| Auteur: |
Carlos Fernando de Oliveira Ricardo Sobhie Diaz Abdallah Harmache Lisa M. Frenkel Phalguni Gupta Gerald H. Learn James I. Mullins Michael P. Busch |
| Verschenen in: |
American journal of infectious diseases |
| Paginering: | Jaargang 4 (2008) nr. 4 pagina's 244-256 |
| Jaar: |
2008 |
| Inhoud: |
Problem statement: We studied in detail a case in which a nurse caring for an HIV-infected child suffered a deep-laceration accident with contaminated blood. Approach: The patient had been treated with zidovudine (ZDV) and the nurse became infected despite prophylactic use of ZDV initiated 2 h after the accident. A reactive anti-HIV-1/2 EIA and an indeterminate western blot (gp120/160 reactivity) were obtained from the nurse on the day of the accident, suggesting preexposure infection. However, a negative western blot and positive DNA PCR were documented 10 days after the accident and seroconversion occurred an additional two weeks later. Results: Phylogenetic analyses of HIV-1 tat and C2-C4-gp120 env regions confirmed that the nurse infected by two different HIV-1 strains present in the child. Strains present in both subjects revealed multinucleoside resistant HIV-1. Dilutional serological studies using 10 HIV-infected patients’ sera demonstrated that passive seroreactivity could occur with infusion of less than 1 uL of blood when highly sensitive assays are employed. Conclusion: This is the first well-documented case of passive HIV antibody detection after a percutaneous exposure. Reactive baseline serology should not be assumed to represent prior infection nor exclude prophylaxis. Transmission of drug-resistant HIV-1 corroborates the medical history and supports use of drug history and resistance testing to guide antiretroviral prophylaxis. |
| Uitgever: |
Science Publications (provided by DOAJ) |
| Bronbestand: |
Elektronische Wetenschappelijke Tijdschriften |
Details van artikel 7 van 10 gevonden artikelen
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