LOS ACCIDENTES LABORALES EN LA ERA DEL VIH, SOLUCIONES A UN PROBLEMA CRECIENTE

(especial para SIIC © Derechos reservados)
Para disminuir el riesgo de transmisión del HIV por un accidente ocupacional entre los trabajadores de la salud es necesario utilizar medidas de prevención universal, profilaxis posexposición cuando esté indicada y, por sobre todas las cosas, tomar conciencia de este grave problema.
wig9.jpg Autor:
Naveet Wig
Columnista Experto de SIIC

Institución:
All India Institute of Medical Sciences, Department of Internal Medicine


Artículos publicados por Naveet Wig
Coautores
Surya Prakash Bhatt* Ankit Sakhuja** Surendra Kumar Malhotra*** 
MBBS, MD, All India Institute of Medical Sciences, Department of Internal Medicine, Nueva Delhi, India*
MBBS Student, All India Institute of Medical Sciences, Department of Internal Medicine, Nueva Delhi, India**
MBBS, MD, Post Graduate Institute of Medical Education and Research, Department of Anesthesia, Chandigarh, India***
Recepción del artículo
30 de Mayo, 2006
Aprobación
16 de Junio, 2006
Primera edición
1 de Septiembre, 2006
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
El VIH/sida cambió la forma en que la profesión médica trata a los pacientes. Algunos médicos desinformados todavía le dan la espalda a casos sospechados o confirmados de VIH/sida por temor a contraer la enfermedad ellos mismos, especialmente en el mundo en vías de desarrollo. Aumentar el conocimiento de las medidas de prevención universal y las formas de contagio del VIH resultó en tratamientos mejores para estos pacientes. Los trabajadores de la salud se exponen cada vez más a pacientes con VIH/sida, de los cuales un gran número es clínicamente silente. Hay pocos datos de los países en vías de desarrollo y la tasa de exposición es alta ante la falta de acceso a recursos necesarios para medidas de prevención universal. Al no contar con una vacuna efectiva, las medidas precautorias universales y la profilaxis posexposición siguen siendo el pilar para abordar este riesgo ocupacional. El riesgo de seroconversión luego de una herida penetrante con aguja puede ser reducido por la noción de los fluidos corporales que son más riesgosos y por el conocimiento de la existencia de la profilaxis posexposición luego de la lesión con una aguja posiblemente contaminada con el VIH. La falta de conocimiento del riesgo que implica y las medidas a implementar en el caso de una exposición accidental a fluidos corporales contaminados es alarmante. En la mayoría de los hospitales, los controles laborales para la prevención de la exposición son inadecuados o poco utilizados. Ya es tiempo de que abordemos este tema de enorme e inmediata preocupación para los trabajadores de la salud, con una mayor orientación en el manejo de esta "peste" de los tiempos modernos.

Palabras clave
VIH, exposición ocupacional, conciencia, trabajador de la salud


Artículo completo

(castellano)
Extensión:  +/-10.14 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

Abstract
HIV/AIDS has changed the way the medical profession cares for patients. Uninformed doctors still turn away suspected and confirmed cases of HIV/AIDS for fear of contracting the disease themselves, especially in the developing world. Increasing awareness of universal precautions and the modes of spread of HIV has resulted in better care for such patients. Health care workers (HCWs) are getting increasingly exposed to patients with HIV/AIDS, a large number of whom are clinically silent. Data from developing countries is lacking, and exposure rate is high in the absence of access to resources needed for universal precautions. In the absence of an effective vaccine, universal precautions and post-exposure prophylaxis remain the mainstay of tackling this occupational hazard. The risk of seroconversion after a needlestick injury may be reduced by knowledge of body fluids that are high risk and awareness of postexposure prophylaxis after possible HIV-contaminated needlestick injury. The lack of awareness of risk involved and the measures to be taken in case of accidental exposure to contaminated body fluids is alarming. In most hospitals, work-practice controls for exposure prevention are either inadequate or underutilized. It is high time we tackled this issue of immense immediate concern to health care professionals, with a larger bearing on handling this plague of modern times.

Key words
HIV, occupational exposure, awareness, health care worker


Full text
(english)
para suscriptores/ assinantes

Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Infectología
Relacionadas: Anestesiología, Atención Primaria, Bioética, Bioquímica, Cirugía, Cuidados Intensivos, Emergentología, Enfermería, Inmunología, Medicina del Trabajo, Medicina Interna, Medicina Legal, Nefrología y Medio Interno, Salud Pública



Comprar este artículo
Extensión: 10.14 páginas impresas en papel A4

file05.gif (1491 bytes) Artículos seleccionados para su compra



Enviar correspondencia a:
Naveet Wig, All India Institute of Medical Sciences, Department of Medicine, 110029, Nueva Delhi, India
Bibliografía del artículo
1. UNAIDS/WHO AIDS epidemic update Dec 2004.
2. Anderson AF, Zheng Q, Wu G, et al. Human immunodeficiency virus knowledge and attitudes among hospital-based healthcare professionals in Guangxi Zhuang Autonomous Region, People's Republic of China. Infect Control Hosp Epidemiol 2003; 24(2):128-31.
3. Aboulafia DM. Occupational exposure to human immunodeficiency virus: what healthcare providers should know Cancer Pract 1998; 6(6):310-7.
4. Bell DM. Occupational risk of human immunodeficiency virus infection in healthcare workers: an overview. Am J Med 1997; 102 (suppl 5B):9-15.
5. Ippolito G, Puro V, De Carli G, Italian Study Group on Occupational Risk of HIV Infection.The risk of occupational human immunodeficiency virus in health care workers. Arch Int Med 1993; 153:1451-8.
6. Caillot JL, Voigloi F, Gilly F, et al. The occupational risk run by French surgeons: a disturbing perspective. AIDS 2000; 14:2061-2063.
7. Cardo DM, Culver DH, Ciesielski CA, et al. A case-control study of HIV seroconversion in health care workers after percutaneous exposure. NEJM 1997; 337(21):1485-90.
8. Mast ST, Woolwine JD, Gerberding JL. Efficacy of gloves in reducing blood volumes transferred during simulated needlestick injury. J Infect Dis 1993; 168(6):1589-92.
9. Resnick L, Veren K, Salahuddin SZ, et al. Stability and inactivation of HTLV-111/LAV under clinical and laboratory environments. JAMA 1986:255(14):1887-91
10. Wig N. HIV: awareness of management of occupational exposure in health care workers. Indian J Med Sci 2003; 57(5):192-8.
11. Menon V, Bharucha K. Acquired immunodeficiency syndrome and health care professionals. J Assoc Physicians India 1994; 42(1):22-3.
12. Kubde SS, Zodpey SD, Vasudeo ND. AIDS awareness among nursing students. Indian J Public Health 1995; 39(3):109-12.
13. Dobe M. Awareness on AIDS among health care professionals. Indian J Public Health 1995; 39(3):105-8.
14. Odujinrin OM, Adegoke OA. AIDS: awareness and blood handling practices of health care workers in Lagos, Nigeria. Eur J Epidemiol 1995; 11(4):425-30.
15. Najmi RS. Awareness of health care personnel about preventive aspects of HIV infection/AIDS and their practices and attitudes concerning such patients. J Pak Med Assoc 1998; 48(12):367-70.
16. S E Duff. Surgeons' and occupational health departments' awareness of guidelines on post-exposure prophylaxis for staff exposed to HIV: telephone survey BMJ 1999; 319:162.
17. Scoular A, Watt AD, Watson M, et al. Knowledge and attitudes of hospital staff to occupational exposure to bloodborne viruses. Commun Dis Public Health 2000; 3(4):247-9.
18. Tibdewel SS, Wadhva SK. HIV/AIDS awareness among hospital employees. Indian J Med Sci 2001; 55(2):69-72.
19. Chogle NL, Chogle MN, Divatia JV, et al. Awareness of post-exposure prophylaxis guidelines against occupational exposure to HIV in a Mumbai hospital. Natl Med J India 2002; 15(2):69-72.
20. Tokars JI, Bell DM, Culver DH, et al. Percutaneous injuries during surgical procedures. JAMA 1992; 267:2899-2904.
21. Centers for Disease Control and Prevention. Evaluation of blunt suture needles in preventing percutaneous injuries among health-care workers during gynecologic surgical procedures-New York City, March 1993-June 1994. Morbid Mortal Weekly Rep 1997; 46:25-29.
22. Centers for Disease Control and Prevention. Evaluation of safety devices for preventing percutaneous injuries among health-care workers during phlebotomy procedures-Minneapolis-St. Paul, New York City, and San Francisco, 1993-1995. Morbid Mortal Weekly Rep 1997; 46:20-25.
23. O'Neill TM, Abbott AV, Radecki SE. Risk of needlesticks and occupational exposures among residents and medical students. Arch Intern Med 1992; 152(7):1451-6.
24. Hamory BH. Underreporting of needlestick injuries in a university hospital. Am J Infect Control 1983; 11(5):174-7.
25. Connor EM, Sperling RS, Gelber R, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med 1994; 331:1173-80.
26. Lindegren ML, Byers RH Jr, Thomas P, et al. Trends in perinatal transmission of HIV/AIDS in the United States. JAMA 1999; 282:531-8.
27. Sperling RS, Shapiro DE, Coombs RW, et al. Maternal viral load, zidovudine treatment, and the risk of transmission of human immunodeficiency virus type 1 from mother to infant. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med 1996; 335:1621-9.
28. Eastman PS, Shapiro DE, Coombs RW, et al. Maternal viral genotypic zidovudine resistance and infrequent failure of zidovudine therapy to prevent perinatal transmission of human immunodeficiency virus type 1 in pediatric AIDS Clinical Trials Group Protocol 076. J Infect Dis 1998; 177:557-64.
29. Kind C, Rudin C, Siegrist CA, et al. Prevention of vertical HIV transmission: additive protective effect of elective Cesarean section and zidovudine prophylaxis. Swiss Neonatal HIV Study Group. AIDS 1998; 12:205-10.
30. Simpson BJ, Shapiro ED, Andiman WA. Reduction in the risk of vertical transmission of HIV-1 associated with treatment of pregnant women with orally administered zidovudine alone. J Acquir Immune Defic Syndr Hum Retrovirol 1997; 14:145-52.
31. Bulterys M, Orloff S, Abrams E. Impact of zidovudine post-perinatal exposure prophylaxis (PPEP) on vertical HIV-1 transmission: a prospective cohort in four U.S. Cities [Abstract 15]. Global Strategies for the Prevention of HIV Transmisison from Mothers to Infants. Toronto, Ontario, Canada; Sept 1-6 1999.
32. Saba J. The PETRA Trial Study Team. Interim analysis of early efficacy of three short ZDV/3TC combinations regimens to prevent mother-to-child transmission of HIV-1: the PETRA trial [Abstract S7]. Proceedings from the 6th Annual Conference on Retroviruses and Opportunistic Infections. Chicago, Illinois; 31 Jan-4 Feb 1999.
33. Blanche S. Zidovudine-Lamivudine for Prevention of Mother to Child HIV-1 Transmission [Abstract 267]. Proceedings from the 6th Annual Conference on Retroviruses and Opportunistic Infections. Chicago, Illinois; 31 Jan-4 Feb 1999.
34. Guay LA, Musoke P, Fleming T, et al. Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomised trial. Lancet 1999; 354:795-802.
35. Lorenzi P, Spicher VM, Laubereau B, et al. Antiretroviral therapies in pregnancy: maternal, fetal and neonatal effects. Swiss HIV Cohort Study, the Swiss Collaborative HIV and Pregnancy Study, and the Swiss Neonatal HIV Study. AIDS 1998; 12:F241-7.
36. Shaffer N, Chuachoowong R, Mock PA, et al. Short-course zidovudine for perinatal HIV-1 transmission in Bangkok, Thailand: a randomised controlled trial. Bangkok Collaborative Perinatal HIV Transmission Study Group. Lancet 1999; 353:773-80.
37. Wiktor SZ, Ekpini E, Karon JM, et al. Short-course oral zidovudine for prevention of mother-to-child transmission of HIV-1 in Abidjan, Côte d'Ivoire: a randomised trial. Lancet 1999; 353:781-5.
38. Dabis F, Msellati P, Meda N, et al. Six-month efficacy, tolerance, and acceptability of a short regimen of oral zidovudine to reduce vertical transmission of HIV in breastfed children in Côte d'Ivoire and Burkina Faso: a double-blind placebo- controlled multicentre trial. DITRAME Study Group. Lancet 1999; 353:786-92.
39. MMWR , June 29, 2001 / Vol. 50 / No. RR-11
40. Quek JT, Li SC. A study of the effectiveness of AIDS health education interventions among the adolescent population of Singapore. Singapore Med J 2002; 43(7):359-64.
41. Shain RN, Perdue ST, Piper JM, et al. Behaviors changed by intervention are associated with reduced STD recurrence: the importance of context in measurement. Sex Transm Dis 2002; 29(9):520-9.
42. Williams BG, Taljaard D, Campbell CM, et al. Changing patterns of knowledge, reported behavior and sexually transmitted infections in a South African gold mining community. AIDS 2003; 17(14):2099-107.
43. Jameson CP, Glover PH. AIDS education in schools--awareness, attitudes and opinions among educators, theology students and health professionals. S Afr Med J 1993; 83(9):675-9.
44. Dutta C. A study on the impact of awareness programme imparted to in-service nursing staff on their knowledge regarding AIDS. Indian J Public Health 1993; 37(1):23-5.
45. Ray SK, Saha I, Mandal AK, et al. An assessment of AIDS awareness program--for I.C.D.S. functionaries. Indian J Public Health 1995; 39(3):100-4.

 
 
 
 
 
 
 
 
 
 
 
 
Está expresamente prohibida la redistribución y la redifusión de todo o parte de los contenidos de la Sociedad Iberoamericana de Información Científica (SIIC) S.A. sin previo y expreso consentimiento de SIIC.
ua31618
Inicio/Home

Copyright siicsalud © 1997-2024 ISSN siicsalud: 1667-9008