Investigation of Potential HIV Transmission to the Patients of an HIV-Infected Surgeon

Rogers, Audrey Smith; Froggatt, John W.; Townsend, Timothy R.; Gordon, Toby A.; Brown, Andrew J. Leigh; Holmes, Edward C.; Zhang, Lin Qi; Moses, Hamilton

doi:10.1001/jama.1993.03500140047034

Cited by 44 publications

(8 citation statements)

References 14 publications

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“…The best way to obtain accurate estimates for the risk would be to perform a series of retrospective studies of individuals treated by HCV-infected medical personnel as has been done for human immunodeficiency virus. [14][15][16][17][18][19][20] To our knowledge, such retrospective investigations of large numbers of patients treated by HCVinfected health care workers have not been published.…”

mentioning

confidence: 99%

Risk of Hepatitis C Virus Transmission From an Infected Gynecologist to Patients<subtitle>Results of a 7-Year Retrospective Investigation</subtitle>

Roß¹

2002

Arch Intern Med

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mentioning

confidence: 99%

Risk of Hepatitis C Virus Transmission From an Infected Gynecologist to Patients<subtitle>Results of a 7-Year Retrospective Investigation</subtitle>

Roß¹

2002

Arch Intern Med

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“…Molecular epidemiology analyses of rapidly evolving microorganisms have to be framed within evolutionary theory since only this provides the necessary concepts to ascertain proximal and distal relatedness from the observed genetic variation [18,19]. These principles have been successfully applied in previous cases of HIV transmission brought to courts [4,7,20,21] and to many other cases of HIV and HCV transmissions that did not lead to legal investigations [2,5,22-24]. However, none of these involved the investigation and analysis of a large number of potential recipients of the virus from the same source, which continued evolving during the long period in which infections occurred in the case considered here.…”

Section: Discussionmentioning

confidence: 99%

Molecular evolution in court: analysis of a large hepatitis C virus outbreak from an evolving source

et al. 2013

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BackgroundMolecular phylogenetic analyses are used increasingly in the epidemiological investigation of outbreaks and transmission cases involving rapidly evolving RNA viruses. Here, we present the results of such an analysis that contributed to the conviction of an anesthetist as being responsible for the infection of 275 of his patients with hepatitis C virus.ResultsWe obtained sequences of the NS5B and E1-E2 regions in the viral genome for 322 patients suspected to have been infected by the doctor, and for 44 local, unrelated controls. The analysis of 4,184 cloned sequences of the E1-E2 region allowed us to exclude 47 patients from the outbreak. A subset of patients had known dates of infection. We used these data to calibrate a relaxed molecular clock and to determine a rough estimate of the time of infection for each patient. A similar analysis led to an estimate for the time of infection of the source. The date turned out to be 10 years before the detection of the outbreak. The number of patients infected was small at first, but it increased substantially in the months before the detection of the outbreak.ConclusionsWe have developed a procedure to integrate molecular phylogenetic reconstructions of rapidly evolving viral populations into a forensic setting adequate for molecular epidemiological analysis of outbreaks and transmission events. We applied this procedure to a large outbreak of hepatitis C virus caused by a single source and the results obtained played a key role in the trial that led to the conviction of the suspected source.

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“…HIV-positive health care workers (HCW) have come under particular scrutiny. The low risk of transmission from HCW to patient is estimated variously as ranging from 1 in 42,000 to 1 in 1,000,000,104 or unlikely to occur more frequently than once/1000 person-hours of surgical exposure 105. Scully and Porter in a review of the CDC studies106 concluded that HIV transmission from HCW to patient is exceedingly improbable and almost impossible where recommended infection-control procedures are implemented.…”

Section: Hiv-positive Health Care Workersmentioning

confidence: 99%

Confidentiality of the medical records of HIV-positive patients in the United Kingdom – a medicolegal and ethical perspective

Williams¹

2011

RMHP

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This article examines the legal and ethical issues that surround the confidentiality of medical records, particularly in relation to patients who are HIV positive. It records some historical background of the HIV epidemic, and considers the relative risks of transmission of HIV from individual to individual. It explains the law as it pertains to confidentiality, and reports the professional guidance in these matters. It then considers how these relate to HIV-positive individuals in particular.

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Investigation of Potential HIV Transmission to the Patients of an HIV-Infected Surgeon

Cited by 44 publications

References 14 publications

Risk of Hepatitis C Virus Transmission From an Infected Gynecologist to Patients<subtitle>Results of a 7-Year Retrospective Investigation</subtitle>

Risk of Hepatitis C Virus Transmission From an Infected Gynecologist to Patients<subtitle>Results of a 7-Year Retrospective Investigation</subtitle>

Molecular evolution in court: analysis of a large hepatitis C virus outbreak from an evolving source

Confidentiality of the medical records of HIV-positive patients in the United Kingdom – a medicolegal and ethical perspective

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Investigation of Potential HIV Transmission to the Patients of an HIV-Infected Surgeon

Cited by 44 publications

References 14 publications

Risk of Hepatitis C Virus Transmission From an Infected Gynecologist to Patients<subtitle>Results of a 7-Year Retrospective Investigation</subtitle>

Risk of Hepatitis C Virus Transmission From an Infected Gynecologist to Patients<subtitle>Results of a 7-Year Retrospective Investigation</subtitle>

Molecular evolution in court: analysis of a large hepatitis C virus outbreak from an evolving source

Confidentiality of the medical records of HIV-positive patients in the United Kingdom &ndash; a medicolegal and ethical perspective

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Confidentiality of the medical records of HIV-positive patients in the United Kingdom – a medicolegal and ethical perspective