Infections with biological therapy: strategies for risk minimization in tropical and developing countries.

In recent decades, biological therapy has enabled disease activity control and improved quality of life in patients with autoimmune diseases. These therapies that are involved in immune response modifications and change multiple immunological pathways induce an incremental risk for certain infectious diseases. Though there have been recent advances in risk assessment for biological therapy, there is a lack of data and recommendations for assessing risks in populations with high prevalence of infectious diseases, such as those located in tropical areas and developing countries. We performed a review on infections with biological therapy as well strategies for risk minimization in areas with a high prevalence of tropical diseases.

Occupational exposure to blood borne pathogens among healthcare workers: a cross-sectional study of a registry in Colombia.

BACKGROUND: Occupational exposure to blood borne pathogens caused by percutaneous injuries or mucosal contamination is frequent among Healthcare Workers (HCW). METHODS: A cross-sectional analysis of HCW with an occupational exposure to blood reported to professional risk insurance agencies between 2009 and 2014 was performed. Comparisons between groups according to exposure level (mild, moderate, and severe) were evaluated. RESULTS: Two thousand, four hundred three reports were classified according exposure as mild 2.7 %, moderate 74.8 %, severe 21.9 %. Factors related: health sciences student with mild exposure events [adjusted odds ratio (AOR) 11.91, 95 % CI 5.13-27.61, p < 0.00001], and physician with moderate exposure events (AOR 1.90, 95 % CI 1.17-3.07, p = 0.009). Factors inversely related: physician with severe exposure events (AOR 0.54, 95 % CI 0.32-0.91, p = 0.02) and health sciences student with moderate exposure events (AOR 0.08, 95 % CI 0.04-0.15, p < 0.00001). It was found an important relationship between severe events with infectious diseases specialist assessment, and follow-up adherence. Additionally, a case of Human Immunodeficiency Virus seroconversion was presented (0.0004 %), no other seroconversions were observed. CONCLUSIONS: Occupational exposure events must be managed according to established protocols, but adherence failure was evident with the exception of severe exposure cases. Thus, interventions to enhance occupational safety are required. Occupation must be considered as a risk factor during initial assessment of events.