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July 1, 1998

Simultaneous Infection With HIV and Hepatitis C Virus Following Occupational Conjunctival Blood Exposure

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(1):28. doi:10.1001/jama.280.1.28

To the Editor.—The rate of transmission of human immunodeficiency virus (HIV) after mucous membrane exposure is estimated at 0.09%,1 although few data are available for hepatitis C virus (HCV). Cases of simultaneous HIV and HCV transmission after a needlestick2 and of HIV or HCV infection after mucosal exposure have been reported.1,3 In 1 case of simultaneous HIV and HCV transmission after a needlestick,2 the clinical course was remarkable for rapid progression to hepatic failure and death, suggesting that the accelerated course of hepatic failure could have been related to high HCV load due to simultaneous acquisition of HIV. We previously reported a case of non-A, non-B hepatitis and HIV infection in a health care worker (HCW) after a massive exposure of conjunctiva and oral mucosa to blood, in which the patient progressed to the acquired immunodeficiency syndrome at 4 years.1 Similar findings have been reported after simultaneous infection with HIV and cytomegalovirus.4 We now report a case of simultaneous infection of HIV and HCV following conjunctival blood exposure in a health care worker.

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