广东省2008-2010年HIV职业暴露情况分析

目的了解广东省艾滋病病毒(Human immunodeficiency virus,HIV)职业暴露现状和职业暴露后应急预防处理的情况,完善预防职业暴露感染HIV的防控措施。方法收集广东省2008-2010年报告的HIV职业暴露案例,分析其发生的原因、应急处理情况、预防用药及时性及预防效果。结果广东省2008-2010年共报告380例HIV职业暴露者,医务人员294例,占77.4%;其次为公安人员74例,占19.5%。暴露方式以针刺和切割伤为主,占48.9%。暴露级别以I、II级为主,分别占50.3%和41.8%。88.7%(337/380)的暴露者实施了应急局部处理,85.5%(325/380)的人进行了预防性服药,58.8%(191/325)的人采用了合理的服药方案;14.5%(55/380)未进行预防性服药,其中60.0%(33/55)是真正无需预防性服药。所有病例医学观察12个月后,均未发现HIV抗体阳转。结论医务人员和公安系统人员是HIV职业暴露高发人群,应加强HIV职业暴露的宣教和防护,以减少因职业暴露发生的HIV感染。

An analysis of occupational exposure to HIV in Guangdong Province,2008-2010

Objective To understand the status of occupational exposure to HIV,and to analyze the causes of occupational exposure and status of post-exposure prophylaxis in order to improve the HIV control strategies in Guangdong Province.Methods The information on cases of occupational HIV exposure occurred in Guangdong from 2008 to 2010 was collected by Guangdong Provincial Center for Disease Control and Prevention(CDC).The causes for HIV occupational exposure,the status of post-exposure prophylaxis,timeliness of getting preventive medicines and the effect of post-exposure prophylaxis were analyzed.Results Of the 380 reported cases of occupational HIV exposure,the accidents mainly occurred in health-care personnel(HCP)(77.4%) and policemen(19.5%).As for the exposure mode,most(48.9%) were needle and sharp-cut injuries.As for exposure level,50.3% were first level exposures,41.8% were second level exposures and only 2.6% were third level exposures.After exposure,337 people(88.7%) had urgent treatment and only 58.9% were treated appropriately.Three hundred and twenty five people(85.5%) were treated with HIV post-exposure prophylaxis(PEP),but only 58.8% of them used PEP appropriately.Fifty five people(14.5%) were not treated with PEP,of whom 60% actually did not need PEP.Most of cases did not get preventive medicines within 4 hours.No HIV infection was identified after 12 month follow up.Conclusion HCPs and policemen,especially HCPs,were the high risk group of HIV occupational exposure.It is necessary to implement universal precaution,strengthen the training of related knowledge and reinforce self-protection measures to avoid HIV infection.