Management of patients treated by surgeon with HIV infection

Empfehlungen für chirurgische Therapieplanung und Eingriffe bei Patienten mit AIDS

“…In den folgenden Jahren wurden dann eine Reihe von sog. ¹Look-back-Studienª durchgeführt, die den HIV-Serostatus von Patienten kontrollierten, die zuvor in zahnmedizinischer oder chirurgischer Behandlung bei HIV-positiven ¾rzten waren [2,8,12,27,33,38,42,44,46], wobei in keinem weiteren Fall eine HIV-Übertragung nachgewiesen werden konnte. Erst 1997 wurde durch das französische Ge-ü ý þ Die umfassendste und auf der Grundlage des derzeitigen Standes der Wissenschaft basierenden Stellungnahme hat kürzlich die ¹Society for Healthcare Epidemiology of America (SHEA)ª mit dem Titel ¹Manage-ment of healthcare workers infected with Hepatitis B virus, Hepatitis C virus, human immunodeficiency virus, or other bloodborne pathogensª herausgegeben [15].…”

Possible Transmission of Human Immunodeficiency Virus to a Patient During an Invasive Dental Procedure

“…However, the symptoms in this patient did not include fever, rash, or general¬ ized lymphadenopathy, which have been described in most cases of acute retroviral syndrome.4 Also, the time be¬ tween the dental procedure and the de¬ velopment of AIDS (24 months) was short; 1% of infected homosexual/bisex¬ ual men and 5% of infected transfusion recipients develop AIDS within 2 years of infection. 5,6 Prospective investigations of HIV transmission from patients to health¬ care workers indicate that the risk for HIV transmission after percutaneous exposure to HIV-infected blood aver¬ ages 0.4%.7 Four investigations have been reported that attempted to assess the risk of HIV transmission from in¬ fected health-care workers to their pa¬ tients (8)(9)(10)(11). In the largest study, 616 patients who underwent surgery by a general surgeon during the 7 years pre¬ ceding his diagnosis of AIDS were test¬ ed for HIV antibody.…”

Escape from collective denial: HIV transmission during surgery.

“…Only three retrospective studies have been reported,71314 yet in Britain alone we estimate that six dentists and 1-6 surgeons have had AIDS diagnosed.15 16 In the largest American investigation, testing for HIV antibodies was offered to 1652 patients contacted after a surgeon developed AIDS; 616 (37%) accepted testing and only one positive result was found in a known intravenous drug misuser.3 In a British study 339 patients operated on by a surgeon subsequently found to be HIV positive were contacted and 76 (22%) were tested, all ofwhom had negative results. 7 Despite the reassurance of these reports, similarities in the modes of transmission of hepatitis B virus and HIV and the evidence of transmission during dental surgery suggest that perioperative infection will occur, although it is uncertain how often. HIV infection has a long latency so that cases of AIDS appear a long time after surgery and will be more difficult to relate to a surgical event than acute hepatitis associated with hepatitis B virus.…”