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LOW RISK OF HIV TRANSMISSION FROM PROVIDERS.

Three studies indicate that the risk of HIV transmission from health-care providers to patients is extremely low.

The first used AIDS registries and follow-up data from 1131 patients of an HIV-infected surgeon who worked at Johns Hopkins hospital from 1984 to 1990. The surgeon's infection date is unknown, but he developed Kaposi's sarcoma in 1990 and resigned 2 months later. There was no evidence of HIV transmission to any patient during 369 person-hours of surgical exposure (mostly breast surgery).

The second study collected follow-up data on 1192 patients treated by a Florida dentist during the 5.6 years before he developed AIDS. Five of the 124 patients who died had HIV infection, but all 5 were homosexuals or used illicit IV drugs. HIV infection was documented in 5 of 900 living patients who were tested, but only 1 of the 5 denied high-risk behavior. DNA analysis of HIV strains indicated that the dentist was not the source of these infections.

The third study followed 2317 patients who had surgery performed from January, 1978 through June, 1991 by an orthopedic surgeon diagnosed with HIV in June, 1991. Half the former patients had HIV tests; all were negative. Vital records and AIDS registries gave no evidence of surgeon-to- patient spread.

These data indicate that the risk of acquiring HIV infection from health-care providers is extremely low, but they do not prove that no risk exists. Further research is needed before the public can be completely reassured.

— THL

Published in Journal Watch General Medicine April 23, 1993

Citation(s):

Mishu B. HIV-infected surgeons and dentists: looking back and looking forward. JAMA 1993 Apr 14 269 1843-1844.

• Medline abstract (Free)

von Reyn CF et al. Absence of HIV transmission from an infected orthopedic surgeon: a 13-year look-back study. JAMA 1993 Apr 14 269 1807-1811.

• Medline abstract (Free)

Dickinson GM et al. Absence of HIV transmission from an infected dentist to his patients: an epidemiologic and DNA sequence analysis. JAMA 1993 Apr 14 269 1802-1806.

• Medline abstract (Free)

Rogers AS et al. Investigation of potential HIV transmission to the patients of an HIV-infected surgeon. JAMA 1993 Apr 14 269 1795-1801.

• Medline abstract (Free)