Peculiarities of conducting an examination of the connection with the profession of diseases from the impact of biological factors

The coronavirus epidemic in 2020–2022 has brought the health of healthcare workers to the forefront. Biological factors have always been a leading threat to healthcare workers' health. Before the pandemic, tuberculosis was the leading occupational disease among healthcare workers in the Russian Federation due to exposure to biological factors. In rarer cases, parenteral infections such as HIV and hepatitis C can also be contracted in the workplace.

A case is presented in which the possibility of a combination of two occupational diseases — tuberculosis and HIV — was discussed in one patient. The absence of documentary evidence of the possibility of HIV infection (absence of emergency situations) in the performance of professional duties by the ward nurse, the absence of witness testimony of the fact of an emergency situation in the workplace, the impossibility of reliably proving by means of phylogenetic analysis the fact of transmission of the HIV pathogen from a specific patient to the ward nurse (based on the results of an independent phylogenetic analysis of three extended regions of the HIV-1 genome, it was established that the studied HIV-1 samples isolated from patient No. 3 and the nurse belong to the same genetic variant of the HIV subtype, the most common in the territories of the Krasnoyarsk Territory, therefore, their infection with HIV infection could have occurred with the HIV genome circulating in the territory of the Krasnoyarsk Territory), the absence of infection with viral hepatitis C in the nurse, with infection with HIV and hepatitis C established in patient No. 3, do not allow us to speak about the professional nature of the nurse's HIV infection.

It has been shown that when determining whether HIV infection is related to one's occupation, documentary evidence of the possibility of HIV infection occurring while performing one's job duties is necessary, with mandatory registration of the emergency in the emergency log.

Genotyping and phylogenetic analysis of nucleotide sequences can be used as an additional tool in the epidemiological investigation of HIV cases presumably associated with the provision of medical care or other complex cases from an epidemiological perspective.

The distinguishing feature of occupational diseases caused by biological factors is not exposure and duration of work experience, but the clinical course and epidemiological history. Close collaboration between specialists in occupational medicine, epidemiologists, infectious disease specialists, and phthisiologists is essential to resolve expert issues.

Contribution:
Zakharinskaya O.N. — article concept and design, writing, editing;
Strizhakov L.A. — concept, design, and editing;
Pavlova N.Yu. — concept and design, writing, editing;
All co-authors — approving of the final version of the article.

Funding. Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 16.07.2025 / Accepted: 23.08.2025 / Published: 30.10.2025

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