What is the risk of transmission of HIV after exposure to body fluids from an HIV-infected patient?

Updated: Jul 27, 2020
  • Author: Ana Elizabeth Markelz, MD, FACP, FIDSA; Chief Editor: John Bartlett, MD  more...
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Answer

Answer

The risk of transmission of HIV after exposure to body fluids from an HIV-infected patient is generally low. [8] Typical exposures result from percutaneous exposure to contaminated sharps such as needles, scalpels, and broken glass. Needlesticks such as from a large-bore hollow needle are thought to carry a higher risk of transmission. Other factors for higher risk are detailed in Table 1. Nonintact skin exposures occur when the medical worker has evidence of compromised skin integrity such as an abrasion, dermatitis, or open wound. Intact skin is considered an effective barrier against HIV infection, and contamination by blood or other fluids is not considered an exposure. From a review [3] in the era prior to highly active antiretroviral therapy (HAART), the following risks of HIV transmission were found:

Table 1. Risk of Transmission of HIV (Open Table in a new window)

Route of Exposure

Risk with HIV-Positive Source

Factors Increasing Risk

Percutaneous

≈ 1 in 300 (0.3%)

Hollow bore needles, visibly bloody devices, deep injury, source with terminal illness

Cutaneous

< 1 in 1000 (0.09%)

Must involve nonintact skin integrity

Mucous membrane

≈ 1 in 1000 (0.09%)

High viral load in source


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