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Transmission of Human Immunodeficiency Virus in a Dental Practice

Carol Ciesielski, MD; Donald Marianos, DDS, MPH; Chin-Yih Ou, PhD; Robert Dumbaugh, DDS, MPH; John Witte, MD, MPH; Ruth Berkelman, MD; Barbara Gooch, DMD, MPH; Gerald Myers, PhD; Chi-Ching Luo, PhD; Gerald Schochetman, PhD; James Howell, MD, MPH; Alan Lasch, DDS, MSPH; Kenneth Bell, BS; Nikki Economou, BS; Bob Scott, BS; Lawrence Furman, DDS, MPH; James Curran, MD, MPH; and Jaffe Harold, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: Carol Ciesielski, MD, Division of HIV/AIDS, E-47, Centers for Disease Control, 1600 Clifton Road N.E., Atlanta, GA 30333.

Current Author Addresses: Drs. Ciesielski, Ou, Berkelman, Luo, Schochetman, Curran, and Jaffe and Mr. Bell and Ms. Economou:Division of HIV/AIDS, Centers for Disease Control, 1600 Clifton Road N.E., Atlanta, GA 30333.

Drs. Marianos and Gooch: Division of Oral Health, National Center for Preventive Services, Centers for Disease Control, 1600 Clifton Road, N.E., Atlanta, GA 30333.

Drs. Dumbaugh, Howell, and Lasch and Mr. Scott: Florida Department of Health and Rehabilitative Services, District IX, 111 Georgia Avenue, West Palm Beach, FL 33401.

Dr. Witte: Florida Department of Health and Rehabilitative Services, 1317 Winewood Blvd., Talahassee, FL 32301.

Dr. Myers: T10, MSK710, Los Alamos National Laboratories, Los Alamos, NM 87545.

Dr. Furman: USPHS, Parklawn Bldg, Room 6A-30, 5600 Fishers Lane, Rockville, MD 20857.

Ann Intern Med. 1992;116(10):798-805. doi:10.7326/0003-4819-116-10-798
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Objective: To determine if patients of a dentist with the acquired immunodeficiency syndrome (AIDS) became infected with human immunodeficiency virus (HIV) during their dental care and, if so, to identify possible mechanisms of transmission.

Design: Retrospective epidemiologic follow-up of the dentist, his office practice, and his former patients.

Setting: The practice of a dentist with AIDS in Florida.

Participants: A dentist with AIDS, his health care providers and employees, and former patients of the dentist, including eight HIV-infected patients.

Measurements: Identification of risks for HIV transmission (if present), degree of genetic relatedness of the viruses, and identification of infection control and other office practices.

Results: Five of the eight HIV-infected patients had no confirmed exposures to HIV other than the dental practice and were infected with HIV strains that were closely related to those of the dentist. Each of the five had invasive dental procedures, done by the dentist after he was diagnosed with AIDS. Four of these five patients shared visit days (P > 0.2). Breaches in infection control and other dental office practices to explain these transmissions could not be identified.

Conclusion: Although the specific incident that resulted in HIV transmission to these patients remains uncertain, the epidemiologic evidence supports direct dentist-to-patient transmission rather than a patient-to-patient route





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