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Rare Transmission of HIV from Surgeon to Patient

It is very rare for HIV to be transmitted from infected surgeons or dentists to patients. The only known case involved a Florida dentist and six of his patients. Luc Montagnier and colleagues now provide a second example, documented with molecular virology evidence, strongly suggesting transmission of HIV from an infected French orthopedist to a patient.

In 1983 the surgeon received a percutaneous injury while operating on a multitransfused patient who died with unknown HIV status. Eleven years later, the orthopedist experienced medical problems prompting diagnostic testing, which revealed HIV seropositivity. The authors will report their epidemiologic analyses elsewhere; here they indicate that the surgeon had operated on 3,004 patients since 1983, only one of whom seroconverted to HIV following her surgery in 1992. This 57-year-old woman had no known risk factors for HIV. Blood samples from the orthopedist and his patient revealed highly related HIV-1 env and gag sequences that suggested a unique, undefined HIV-1 serotype. Thus, it is highly likely that these closely related HIV strains were transmitted from surgeon to patient. Extensive laboratory measures were taken to render cross-contamination of viral strains highly unlikely.

Comment: A highly reputable research group has provided strong molecular virology evidence for nosocomial transmission of HIV from an orthopedist to his patient. This form of transmission is very rare and was not found in this surgeon's 3,003 other patients.

— N Blacklow

Published in Journal Watch Infectious Diseases June 1, 1998

Citation(s):

Blanchard A et al. Molecular evidence for nosocomial transmission of human immunodeficiency virus from a surgeon to one of his patients. J Virol 1998 May 72 4537-4540.

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