OT accidents 2
WHAT IS HIV INFECTION?
THE VIRUS
The acquired immune deficiency syndrome (AIDS) was first described in 1981 and the human immunodeficiency virus (HIV) was first identified in 1983.
- Antibody tests were developed which revealed the HIV status of the individual.
- In 1986 a second strain, HIV 2, was isolated
.
- Like hepatitis B, the virus is present in blood and body fluids, but unlike hepatitis B is relatively easily destroyed outside the body, and is not as infectious as the hepatitis B virus.
- Infection of the surgeon can occur from contamination from infected blood or body fluids, either through an open wound, or from a puncture wound like a needle-stick injury.
- Following infection there is an asymptomatic period during which antibody to the virus is not yet present in the blood, and thus HIV tests will be negative.
- After approximately 6 months the infected individual may seroconvert, and the HIV antibody be detected.
- A high proportion will then progress to develop AIDS.
LOOK FOR
- A common presenting feature is AIDS sufferers is the Kaposi sarcoma, with an incidence of between 25%and 50%. Biopsy of such lesions may be the first indicator for the surgeon that the patient has this disease.
- Kaposi sarcomas present as pink to purple blotches like a bruise or blood blister.
They may be flat or raised.
They are skin cancer arising from the endothelial cells such as those lining blood vessels. Histological, malignant transformation causes the endothelial cells to become stippled with spindle-shaped tumor cells; lymphatic obstruction may occur, but they do not metastasize, and remain multimodal both on the skin and in the alimentary tract.
SURGEON’S RISK.
Despite the worry of surgeons about risks of infection, these risks are small.
- The prevalence rate of HIV 0.3-7% in our country.
Surgeons have been shown to contaminate themselves with blood in 8.7% cases, and sustain penetrating injuries in 1.7% cases
The transmission rate is 0.3-0.4%, yet statistically the risk of sero-conversion for a surgeon is one infection every 8 years in a high-risk area with a case-load of 15000 patients per year.
As small as one infection every 80 years, in a low risk area.
Thus the risk to surgeon at work, is exceptionally low
Any questions be sent to drmmkapur@gmail.com
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