Israeli surgeon allowed to practise

In 2007 an Israeli surgeon specialising in open-heart procedures was found to be HIV positive, and an extensive look-back exercise was conducted in which 545 patients were tested.1

1494 patients who had received cardiothoracic surgery at the hands of the surgeon in the previous ten years were contacted; 545 provided blood samples for testing. (Of the remainder who did not agree to testing, none were listed in the national HIV registry.) None of those tested were infected with HIV, despite the fact that the surgeon had a high viral load (above 100,000 copies/ml) and a very low CD4 count at the time of diagnosis, indicating that the surgeon had been infected with HIV for some years. The surgeon did not report any incidents when blood exposure could have placed patients at risk.

This led the Israeli health ministry to decide that the surgeon could return to work, which was the first time that a public health body has admitted that an HIV-positive healthcare worker has been cleared to carry out invasive surgical procedures since the introduction of antiretroviral therapy.

Their decision specified that:

  • The surgeon could return to work; his or her infection control compliance would be closely monitored. In particular the surgeon would wear two pairs of surgical gloves.
  • The surgeon must maintain good adherence and attend for regular monitoring to ensure that an undetectable viral load and a CD4 count above 200 cells/mm3 is maintained.
  • Prospective patients of the surgeon would not need to be notified of the surgeon’s HIV infection because there is an extremely low risk of HIV transmission if these conditions are met.

The judgement that antiretroviral therapy and viral suppression are risk-reduction measures for HIV transmission echoes the Swiss Federal AIDS Commission's statement in January 2008, which stated that individuals with undetectable viral load on treatment cannot transmit HIV.2

References

  1. Schwaber MJ et al. Investigation of patients treated by an HIV-infected cardiothoracic surgeon - Israel, 2007. MMWR Morb Mortal Wkly Rep 57(53);1413-1415, 2009
  2. Vernazza P et al. Les personnes séropositives ne souffrant d’aucune autre MST et suivant un traitment antirétroviral efficace ne transmettent pas le VIH par voie sexuelle. Bulletin des médecins suisses 89 (5), (English translation, including translator’s affidavit, available at: http://tinyurl.com/cpyt5n Date accessed: 21 July 2013), 30 January 2008
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
close

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.