[HIV occupational infections in gynecology: risk assessment, post-exposure management, and drug prophylaxis]

The average risk of HIV infection after percutaneous exposure to HIV-infected blood is 0.3%. Higher risk factors of HIV transmission to health care worker after percutaneous exposure are deep injury, visible blood on device, procedure involving needle in artery or vein and terminal: Illness in source patient or high viremia. It has been shown that post-exposure use of zidovudine diminishes risk of transmission. In Italy 5 occupational HIV infections in health care workers have been documented. Although prevention of exposure to blood is the best method to avoid occupational risk of HIV infection, nevertheless an adequate management of blood-borne exposure is essential for achieving a safer health care workplace. In this paper we reviewed the modality and the frequency of blood-borne exposures in Italian health care setting, focusing on in obstetric and gynaecology. Finally, Italian recommendation for the management of blood-born exposure, including post-exposure chemoprophylaxis are discussed.