Rethinking Guidelines for HIV-Infected HCWs

HIV transmission from infected healthcare workers (HCWs) to their patients is rare. Nevertheless, in 1991, the CDC recommended that HIV-infected HCWs refrain from performing exposure-prone procedures unless they have sought counsel from an expert panel, and that prospective patients be notified of the HCW’s seropositivity. A new study raises the question of whether the guidelines should be revised.

In 2007, a cardiothoracic surgeon in Israel was diagnosed with advanced HIV infection (CD4 count, 49 cells/mm³; viral load [VL], >100,000 copies/mL) during evaluation for fever. None of the 1669 patients who had been operated on by the surgeon during the preceding decade were listed in Israel’s national registry of HIV-infected individuals. The su…