Molecular Epidemiology of HIV Transmission in a Dental Practice

Abstract

Human immunodeficiency virus type 1 (HIV-1) transmission from infected patients to health-care workers has been well documented, but transmission from an infected health-care worker to a patient has not been reported. After identification of an acquired immunodeficiency syndrome (AIDS) patient who had no known risk factors for HIV infection but who had undergone an invasive procedure performed by a dentist with AIDS, six other patients of this dentist were found to be HIV-infected. Molecular biologic studies were conducted to complement the epidemiologic investigation. Portions of the HIV proviral envelope gene from each of the seven patients, the dentist, and 35 HIV-infected persons from the local geographic area were amplified by polymerase chain reaction and sequenced. Three separate comparative genetic analyses--genetic distance measurements, phylogenetic tree analysis, and amino acid signature pattern analysis--showed that the viruses from the dentist and five dental patients were closely related. These data, together with the epidemiologic investigation, indicated that these patients became infected with HIV while receiving care from a dentist with AIDS.

Source identification in two criminal cases using phylogenetic analysis of HIV-1 DNA sequences

“…The case of a Florida dentist was a high-profile investigation inferring the phylogenetic relationships of HIV-1 in different individuals and establishing that viral sequences from the dentist and six of his patients were more closely related to each other than to unrelated controls (15,16). Other phylogenetic studies have provided support for the transmission of HIV-1 from a French surgeon (17) and a French nurse (18) to their respective patients while receiving care in the hospital.…”

Modelling the Effects of Mass Drug Administration on the Molecular Epidemiology of Schistosomes

“…Models have already been used in directly transmitted pathogens, including sexually transmitted diseases, where contact tracing data may not be complete, but where genome data can inform on infection networks (e.g. HIV transmission in a dental practise (Ou et al, 1992) as well as theoretical pathogen models using evolutionary trees resulting from different evolutionary processes (Nee et al, 1994). In microparasites with rapid in-host evolution sensitivity of phylogenetic based networks may be reduced (Resik et al, 2007).…”

The molecular epidemiology of parasite infections: Tools and applications

“…Important information can be obtained from intraspecific gene phylogenies even in the absence of a population genetic model [e.g. 34], but an explicit population genetic model provides extra power to test specific hypotheses about evolutionary processes [35].…”