International Journal of STD & AIDS > Volume 20, Number 12 > Pp. 828-833

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Reid, S Articles by Juma, O A PubMed PubMed Citation Social Bookmarking                      What's this?

Reviews

Minimum infective dose of HIV for parenteral dosimetry

S Reid BS ^*  and O A Juma MD MPH 

^* School of Community Health Sciences, University of Nevada at Las Vegas, NV, USA; Bagamoyo District Hospital, University of New South Wales, Sydney, Australia

Correspondence to: S Reid, 431 Sunburst Drive, Henderson, NV 89002, USA Email: inkwell_11{at}yahoo.com

The probability of HIV-1 transmission in a small blood exposure such as a needlestick injury or an unsafe medical injection has been estimated indirectly. Now that several comparable laboratory simulations have provided data on inoculum volumes for such exposures, the epidemiological evidence supporting these estimates can be validated and qualified using dosimetry. This review of data on infective titre, viral load and injection inoculum volume compares three approaches to HIV dosimetry. Agreement across the three approaches indicates that unsafe medical injections are several times more likely to transmit HIV-1 than needlestick accidents, and that the risk remains substantial if injection equipment is wiped, rinsed or flushed prior to re-use. The 50% infective dose of HIV in blood exposures ranges from one virion (two copies RNA) in primary infection with CCR5 co-receptor using strains of HIV-1 to 65,000 copies HIV-1 RNA in blood from an asymptomatic source patient. The median transmission risks for unsafe intravenous or intramuscular injections using equipment cleaned but not sterilized after use on a symptomatic pre-AIDS patient are 1.8% (95% confidence interval [CI] 0.1–3.2%) and 0.8% (95% CI 0.1–1.4%), respectively.

Key Words: HIV • nosocomial • iatrogenic • parenteral • Africa

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J J Potterat AIDS epidemiology in Africa: a changing of the guard Int J STD AIDS, December 1, 2009; 20(12): 812 - 815. [Abstract] [Full Text] [PDF]

				S. Reid Unsafe health care in Africa: a joint statement of the research agenda Int J STD AIDS, December 1, 2009; 20(12): 879 - 880. [Full Text] [PDF]