Acknowledging that the threat posed by HIV-positive health care providers, including surgeons, to their patients is negligible, the CDC discusses an investigation tracking the patients of an HIV-positive cardiothoracic surgeon in Israel. Cardiothoracic surgery is among the most invasive medical interventions, which is why Israeli officials were concerned when this surgeon, who had been practicing for more than 10 years and had treated more than 1600 patients, tested positive for HIV. In response, officials conducted an investigation of patients treated by the surgeon in the 10 years prior to his diagnosis and determined that none had tested positive for HIV. They were able to confirm this with near certainty by comparing the list of patients with the national HIV registry, on which all diagnosed individuals with HIV must be listed. After determining that the surgeon did not pose a threat to his patients, the surgeon was cleared to continue with his practice, with no need to notify patients of his HIV status, as long as he continued to abide by established infection control protocols.
In the editorial following the report, the CDC stated that “the data in this and other studies published since the CDC guidelines of 1991, considered together, argue for a very low risk for provider-to-patient HIV transmission in the present era and could form the basis for national and international public health bodies to consider issuing revised guidelines for medical institutions faced with HIV infection in a health-care worker performing exposure-prone procedures.” This is a significant acknowledgment in light of the fact that the CDC has yet to revisit the overly restrictive guidelines they issued in 1991 regarding the practice of HIV-positive health care workers. To view a commentary on the CDC guidelines by Professor Larry Gostin, click here.