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August 10, 1994

Transmission of Zidovudine-Resistant HIV During a Bloody Fight

Author Affiliations

The Italian Program on Occupational Risk of HIV Infection Coordinating Center Lazzaro Spallanzani Hospital for Infectious Diseases Rome, Italy
University of Pisa Pisa, Italy
University La Sapienza Rome, Italy

JAMA. 1994;272(6):433-434. doi:10.1001/jama.1994.03520060031019

To the Editor.  —We report a case of probable human immunodeficiency virus (HIV) transmission during a bloody fight.The source patient (subject 1) was a 29-year-old former intravenous drug user, HIV-positive since 1989, treated with zidovudine from December 1989 to December 1990, and diagnosed as having the acquired immunodeficiency virus (AIDS) in June 1991. In February 1992 his CD4+ lymphocyte cell count was 0.032×109/L(32/μL), and he was classified as having AIDS dementia. His brother (subject 2) was 27 years old and had no known risk factors for HIV.On February 29,1992, during a disagreement in the house where both subjects were living, subject 2 attacked subject 1 by repeatedly banging his forehead against the face and forehead of subject 1. Injuries to subject 1 included a nasal hemorrhage that bled profusely and laceration of the central forehead requiring sutures. Subject 2 sustained a supraorbital laceration of the right

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