Information suggesting that zidovudine postexposure prophylaxis (PEP) reduces the risk of human immunodeficiency virus (HIV) transmission after occupational exposure to HIV-infected blood prompted the US Public Health Service to provide guidelines for the use of combination drug therapy for chemoprophylaxis after certain occupational exposures to HIV.1,2 Many health care workers (HCWs) worldwide may take PEP following occupational exposures to HIV.
Phylogenetic analysis of human immunodeficiency virus (HIV) samples based on the C2V3 sequence of the env gene. These sequencing results were independently confirmed by Rob Schuurman, PhD, University of Utrecht, Utrecht, the Netherlands. The strains of HIV infecting the health care workers (HCWs) and source patients (SPs) were compared after amplification by polymerase chain reaction and genetic sequencing. The phylogenetic tree was constructed using the neighbor-joining method. Vertical distances are for clarity only; the length of the horizontal distances are proportional to percent nucleotide changes between sequences and can be read using the scale bar provided. Numbers at the nodes are bootstrap values, generated through a data resampling procedure to show the likelihood for which sequences can be sorted into a cluster. Clusters that are present in 70% or more bootstrap values are considered to be statistically significant and indicate that variants of HIV are more likely to be highly related. In case 1, SRC1-1 and SRC1-2 denote virus from the 2 SP blood sample draws, and HCW1-1 and HCW1-2 denote virus from the 2 HCWs blood sample draws. While SRC1-1 and SRC1-2 were highly related, providing support that the 2 viruses were from the same SP, HCW1-1 and HCW1-2 appeared unrelated to each other and unrelated to the SP virus. In case 2, virus from the SP and HCW (SRC2 and HCW2, respectively) were not related. Other HIV sequences denote HIV reference strains.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 11
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Care at the Close of Life: Evidence and Experience
Overcoming the False Dichotomy of Curative vs Palliative Care for Late-Stage HIV/AIDS: "Let Me Live the Way I Want to Live, Until I Can't"
The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Evidence to Support the Update
All results at
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.