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Low Risk of Transfusion-Associated Bloodborne Infections in England

of her HIV status until she was hospitalized for hepatic complications in June 1996. At that time, she had a high HIV RNA load and low CD4 counts. No exposure to blood was evidenced. To test the hypothesis of a possible nurse-to-patient transmission, phylogenetic analyses were conducted using two HIV-1 genomic regions (pol reverse transcriptase [RT] and env C2C4), each compared with reference strains and large local control sets (57 RT and 41 C2C4 local controls). Extensive analyses using multiple methodologies allowed the testing of robustness of phylogeny inference and assessment of transmission hypotheses. Results excluded nurse 1 and strongly suggested nurse 2 as the source of infection of the patient. Because nurse 2 had advanced HIV disease, whereas the patient had signs of newly acquired infection, the researchers concluded that viral transmission occurred from the healthcare worker to the patient. Although the nurse was also infected with hepatitis C virus, the patient showed no signs of hepatitis C virus infection. The mode of transmission was not identified. FROM: Goujon CP, Schneider VM, Grofti J, Montigny J, Jeantils V, Astagneau P, et al. Phylogenetic analyses indicate an atypical nurse-to-patient transmission of human immunodeficiency virus type 1./ Virol 2000;74:2525-2532.