The surgeon's database for AIDS: a collective review.
BACKGROUND
The human immunodeficiency virus infection and acquired immunodeficiency syndrome have had a dramatic effect on the practice of surgery. Critical issues include quantifying the risk encountered by surgeons when operating on infected patients, the benefits of chemoprophylaxis after injury by a health care worker, the likelihood of infected surgeons transmitting human immunodeficiency virus to patients, and the debate over mandatory testing.


METHODS
Literature review of English-language publications.


RESULTS
The incidence of human immunodeficiency virus infection ranges from 1.3 percent of patients hospitalized at sentinel hospitals to 1.5/1,000 patients in lower risk environments. The rate of percutaneous injury during an operation is 5 percent to 6 percent, and human immunodeficiency virus transmission after percutaneous injury with a needle contaminated with the human immunodeficiency virus is 0.3 percent. Here, we review current Public Health Service recommendations for chemoprophylaxis after percutaneous injury and address the debate over mandatory human immunodeficiency virus testing for patients and surgeons in the context of new information regarding the test for the human immunodeficiency virus.


CONCLUSIONS
Controversial issues regarding acquired immunodeficiency syndrome and the human immunodeficiency virus infection must be addressed by all surgeons on the basis of objective information.
Flum
D R
DR
Department of Surgery, St. Vincents Hospital and Medical Center, New York, NY, USA.
Wallack
M K
MK
D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control; D019380:Anti-HIV Agents / Q000627:therapeutic use; D016208:Databases, Factual; D013502:General Surgery; D006678:HIV / Q000276:immunology; D015483:HIV Antibodies / Q000096:biosynthesis; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D017757:Infectious Disease Transmission, Professional-to-Patient; D016036:Seroepidemiologic Studies; D016635:Universal Precautions; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D015483:HIV Antibodies; D015215:Zidovudine