title: Probable transmission of HIV from an orthopedic surgeon to a patient in France.
abstract: BACKGROUND
  Transmission of HIV from infected health care workers to patients has been documented in only one cluster involving 6 patients of a dentist in Florida. In October 1995, the French Ministry of Health offered HIV testing to patients who had been operated on by an orthopedic surgeon in whom AIDS was recently diagnosed.
  
  
  OBJECTIVE
  To determine whether the surgeon transmitted HIV to patients during operations.
  
  
  METHODS
  Epidemiologic investigation.
  
  
  METHODS
  The practice of an orthopedic surgeon in a French public hospital.
  
  
  METHODS
  1 surgeon and 983 of his former patients.
  
  
  METHODS
  3004 patients who had undergone invasive procedures were contacted by mail for counseling and HIV testing. One HIV-positive patient was interviewed, and DNA sequence analysis was performed to compare the genetic relation of the patient's and the surgeon's viruses. Infection-control precautions and the surgeon's practices were assessed.
  
  
  RESULTS
  Of 983 patients in whom serologic status was ascertained, 982 were HIV negative and 1 was HIV positive. The HIV-positive patient, a woman born in 1925, tested negative for HIV before placement of a total hip prosthesis with bone graft (a prolonged operation) performed by the surgeon in 1992. She had no identified risk for HIV exposure. Molecular analysis indicated that the viral sequences obtained from the surgeon and the HIV-infected woman were closely related. Infection-control precautions were in accordance with recommendations, but blood contact between the surgeon and his patients occurred commonly during surgical procedures.
  
  
  CONCLUSIONS
  An HIV-infected surgeon may have transmitted HIV to one of his patients during surgery.
authors.affiliation: Réseau National de Santé Publique, Saint-Maurice, France. Lot@b3e.jussieu.fr
authors.forename: F
authors.initials: F
authors.lastname: Lot
authors.forename: J C
authors.initials: JC
authors.lastname: Séguier
authors.forename: S
authors.initials: S
authors.lastname: Fégueux
authors.forename: P
authors.initials: P
authors.lastname: Astagneau
authors.forename: P
authors.initials: P
authors.lastname: Simon
authors.forename: M
authors.initials: M
authors.lastname: Aggoune
authors.forename: P
authors.initials: P
authors.lastname: van Amerongen
authors.forename: M
authors.initials: M
authors.lastname: Ruch
authors.forename: M
authors.initials: M
authors.lastname: Cheron
authors.forename: G
authors.initials: G
authors.lastname: Brücker
authors.forename: J C
authors.initials: JC
authors.lastname: Desenclos
authors.forename: J
authors.initials: J
authors.lastname: Drucker
mesh_terms: D001483:Base Sequence; D004279:DNA, Viral; D005260:Female; D005602:France; D015658:HIV Infections / Q000635:transmission* / Q000821:virology; D015497:HIV-1 / Q000235:genetics; D006779:Hospitals, Public / Q000592:standards; D006801:Humans; D017053:Infection Control / Q000592:standards; D017757:Infectious Disease Transmission, Professional-to-Patient; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000379:methods; D010818:Practice Patterns, Physicians'
chemical_list: D004279:DNA, Viral