No hypotheses were stated. The research question was not categorically stated but could be inferred from the background given, and it is this: What factors influence the risk of human immunodeficiency virus (HIV) infection after percutaneous exposure to HIV-infected blood
Design of the study. This is a case-control study that was conducted of health care workers with occupational, percutaneous exposure to HIV-infected blood. The case patients were those who became seropositive after exposure to HIV, as reported by national surveillance systems in France, Italy, the United Kingdom, and the United States. The controls were health care workers in a prospective surveillance project who were exposed to HIV but did not seroconvert.
The dependent variable may be said to be human immunodeficiency virus (HIV) infection after percutaneous exposure to HIV-infected blood. The independent variables may be the factors influencing this risk
Subjects. The study population included 33 case patients (23 from the United States, 5 from France, 3 from the United Kingdom, and 2 from Italy) and 679 controls (from 190 of the U.S. health care facilities involved in the CDC Needlestick Study). Case patients were health care workers who had a documented occupational, percutaneous exposure to HIV-infected blood by a needle stick or a cut with a sharp object, HIV seroconversion that was temporally associated with the exposure, and no other reported concurrent exposure to HIV. Control subjects were health care workers with a documented occupational, percutaneous exposure to HIV-infected blood who were HIV seronegative at the time of exposure and at least six months later.
Case patients were identified through reports to national surveillance systems for occupationally acquired HIV infection that were operated by the Centers for Disease Control and Prevention (CDC), in cooperation with state and local health departments in the United States; the Rseau National de Sant Publique in France; the Centro di Riferimento AIDS in Italy; and the Public Health Laboratory Service Communicable Disease Surveillance Centre in the United Kingdom. Controls were identified through reports to a voluntary CDC surveillance project, Prospective Evaluation of Health Care Workers Exposed to Blood of Patients Infected with HIV, also called the CDC Needlestick Study. This project has enrolled health care workers from approximately 300 health care institutions in the United States since 1983.
All case patients reported in the United States by August 1994 who were exposed after 1987 and all controls exposed after 1987 whose six-month follow-up evaluation was completed as of August 1994 were studied.
Findings. In answer to the research question, the following are the findings: Logistic-regression analysis based on 33 case patients and 665 controls showed that significant risk factors for seroconversion were deep injury (odds ratio_15; 95 percent confidence interval, 6.0 to 41), injury with a device that was visibly contaminated with the source patient's blood (odds ratio_6.2; 95 percent confidence interval, 2.2 to 21), a procedure involving a needle placed in the
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Cardo, D.M., Culver, D.H. Ciesielski, C. A., Srivastava, P.U., Marcus, R., Abiteboul, D., Hepstonstall, J. Ipppolito, G., Lot, F., McKibben, P.S., Bell, D.M. et al. A case-control study of HIV seroconversion in health care workers after percutaneous exposure…
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