How are healthcare workers exposed to HIV?

Updated: Jul 27, 2020
  • Author: Ana Elizabeth Markelz, MD, FACP, FIDSA; Chief Editor: John Bartlett, MD  more...
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HIV may theoretically be transmitted occupationally to medical personnel engaged in many routine medical procedures and activities. After initial exposure, HIV replicates within dendritic cells of the skin and mucosa before spreading through lymphatic vessels and developing into a systemic infection. This delay in systemic spread leads to a window of opportunity for postexposure prophylaxis (PEP) using antiretroviral drugs to block replication of HIV and prevent establishment of chronic HIV infection.

A portal of entry (percutaneous, cutaneous, or mucous membrane) is necessary along with exposure to infectious body fluid. Potentially infectious body fluids include blood, semen, vaginal fluids, amniotic fluids, breast milk, cerebrospinal fluid, pericardial fluid, peritoneal fluid, pleural fluid, and synovial fluid. Exposure to saliva, vomitus, urine, feces, sweat, tears, and respiratory secretions does not pose a risk for HIV transmission unless the fluid is visibly bloody. A bite from an HIV-infected patient with visible bleeding in the mouth that causes bleeding in the healthcare worker is considered an exposure. Splash of blood, visibly bloody fluid, or other potentially infectious material to a mucosal surface (mouth, nose, eyes) is also considered an exposure.

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