云南省德宏州2010-2015年艾滋病病毒职业暴露状况分析

目的 了解云南省德宏州艾滋病病毒（human immunodeficiency virus，HIV）职业暴露发生、暴露后预防以及预后随访现状，为开展和加强HIV职业暴露防护工作提供依据。方法 对德宏州2010-2015年上报的所有HIV职业暴露者的个案登记记录进行汇总和统计分析。结果 2010-2015年期间，德宏州共报告323例，均未发现HIV抗体阳转者。其中220人（68.11%）为女性，229人（70.90%）年龄小于35岁，209人（64.71%）为医务人员。暴露方式以针刺或锐器刺伤为主，占72.14%（233/323）；暴露发生地点以医疗单位为主，占82.66%（267/323）；发生职业暴露后，323人立即对皮肤或粘膜进行清洗或消毒处理，279人在职业暴露后采用了预防性用药，156人完成了28 d的暴露后预防（post-exposure prophylaxis，PEP）疗程，6年HIV职业暴露人数变化浮动较大。结论 坚持"普遍性防护原则"、暴露后立即采取应急措施、暴露评估后尽早接受PEP有益于避免和降低职业暴露者感染HIV的风险。

Analysis on occupational exposure to HIV between 2010 to 2015 in Dehong Prefecture,Yunnan Province

Objective To acquaint the occurrence, post-exposure prophylaxis (PEP) and prognostic follow-up of occupational exposure to HIV from 2010 to 2015 in Dehong Prefecture in Yunnan Province, so as to provide reference for carrying out and tightening the protection work of occupational exposure to HIV. Methods The CDC of Dehong Prefecture collected total occupational HIV exposure cases from 2004 to 2015, which then were put into pooling and statistical analysis. Results From 2010 to 2015, a total of 323 cases of occupational HIV exposure occurred and none suffered HIV infection, of whom 220 (68.11%) were females, of whom 229 (70.90%) were less than 35 years old, and of whom 209 (64.71%) were health care workers. needle or other sharp instrument sticking occupied the most proportion of 72.14% (233/323). Medical facilities were the main areas where the occupational HIV exposure occurred (82.66%, 267/323). After exposure to HIV, total 323 immediately washed or disinfected skin or mucous membranes whereas 279 had received post-exposure prophylaxis(PEP), 156 of 279 completed the 28-day course. The cases of occupational HIV exposure differed largely. Conclusions Insisting on the principle of universal protection, employing timely and emergent treatment and PEP after exposure assessment are helpful for avoiding and reducing HIV infection due to occupational exposure.