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HIV Transmission from Doctor to Patient
HIV transmission from health care provider to patient has been documented only once, in a cluster of patients of a dentist in Florida. Epidemiologists in France now report a second case. An orthopedic surgeon with no other risk factors for HIV infection sustained a needlestick injury in 1983 while operating on a patient of unknown HIV status who had received multiple blood transfusions. Thirty days later, the surgeon developed a febrile illness consistent with primary HIV infection. In 1994, he was diagnosed with HIV encephalopathy. He reported frequent blood exposure during surgical procedures, and frequent cutaneous and percutaneous blood exposure.
After it was learned that the surgeon was HIV positive, 3,004 patients operated on by him between 1983 and 1993 were notified; 983 had HIV tests, and 1 tested positive. This patient had been HIV negative before having hip replacement surgery performed by this surgeon. Two years later the patient, who had no other identifiable risk factors for HIV, was HIV positive. Genetic analysis found similar sequences in the virus taken from the patient and from the physician.
Comment: This case probably represents an extremely rare event: HIV transmission from a physician to his patient. An editorialist from the Centers for Disease Control and Prevention encourages better injury prevention for physicians and recommends that patient exposures to physicians' blood be managed in the same manner as occupational exposures to blood.
— R Saitz
Published in Journal Watch General Medicine January 12, 1999
Citation(s):
Lot F et al. Probable transmission of HIV from an orthopedic surgeon to a patient in France. Ann Intern Med 1999 Jan 5 130 1-6.
- Original article (Subscription may be required)
- Medline abstract (Free)
Gerberding J. Provider-to-patient HIV transmission: How to keep it exceedingly rare. Ann Intern Med 1999 Jan 5 130 64-65.
- Original article (Subscription may be required)
- Medline abstract (Free)
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