Symposium on infections in the compromised host. The acquired immunodeficiency syndrome.

The Acquired Immunodeficiency Syndrome (AIDS) is a recently recognized syndrome caused by a newly described retrovirus, Human T-Cell Lymphotropic Virus-III(HTLV-III). A disease that selectively attacks the immune system, manifested by opportunistic infections and unusual neoplasms, AIDS has continued to be confined primarily to several unique at-risk populations. AIDS has evoked unprecedented interest in the medical community, and care of patients with this nearly universally fatal syndrome presents many unique challenges to the health care team.

Risk of nosocomial infection with human T-cell lymphotropic virus type III/lymphadenopathy-associated virus in a large cohort of intensively exposed health care workers.

To assess the risk of nosocomial transmission of human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV), we prospectively evaluated a cohort of 531 health care workers. One hundred fifty of these employees reported percutaneous or mucous membrane exposures to blood or body fluids from a patient with the acquired immunodeficiency syndrome (AIDS) during the treatment of 238 such patients since 1981. None of these 150 employees had serologic evidence of HTLV-III/LAV infection on follow-up from 6 to 46 months after exposure. Of the 150, 46 were studied immunologically and 29 had lymphocytes cultured for HTLV-III/LAV. Results of all studies were normal. Of the 531 employees, 3 (0.56%) had serologic evidence of HTLV-III/LAV infection. All were seropositive at the time of study entry; none reported adverse nosocomial exposures. All acknowledged membership in one or more established risk groups for AIDS. This study provides strong evidence that the risk of nosocomial transmission of HTLV-III/LAV is extremely low.