Israeli HIV+ surgeon cleared to continue work

Reconsider policies for HIV-infected providers?

In a case that recalls the national turmoil during the Florida HIV dental outbreak in the early 1990s, investigators have determined that HIV provider-to-patient infections remain exceedingly rare.

The case in point occurred in Israel, but was jointly investigated and recently reported by the Centers for Disease Control and Prevention.1 A cardiothoracic surgeon in Israel specializing in open-heart procedures was found to be HIV-positive in January 2007 during evaluation for fever of recent onset. The duration of infection was unknown. A look-back investigation of patients operated on by the infected surgeon during the preceding 10 years was conducted under the auspices of the Israel Ministry of Health to determine whether any surgeon-to-patient HIV transmission had occurred. Of 1,669 patients identified, 545 (33%) underwent serologic testing for HIV antibody. All results were negative. "The results of this investigation add to previously published data indicating a low risk for provider-to-patient HIV transmission," the CDC reported.

The surgeon was allowed to return to work if he agreed to rigorous compliance with infection control, routine health care follow-up and adherence to an antiviral regimen. The panel did not require notification of prospective patients of the surgeon's HIV status because of the extremely low likelihood of transmission to patients if the conditions for resuming surgery were met, the CDC concluded.

Reference

1. Centers for Disease Control and Prevention. Investigation of patients treated by an HIV-infected cardiothoracic surgeon — Israel, 2007. MMWR 2009; 57(53):1,413-1,415.