U.S. Calls for Curbs on AIDS-Infected Doctors

The federal government Monday recommended that AIDS-infected health professionals voluntarily refrain from performing “exposure-prone” procedures in which blood contact might occur.

Dentists, surgeons, physicians and others who practice these procedures should undergo testing for the human immunodeficiency virus and, if infected, should not perform surgery unless they obtain permission and guidance from a special medical review committee, “which will require, at minimum, that potential patients be informed” that the person is infected, the Department of Health and Human Services said in a statement.

The guidelines, which were drafted by the Centers for Disease Control, apply also to the hepatitis B virus, which can cause a life-threatening liver disease.

The guidelines urge that all physicians follow the so-called “universal precautions” against infection. These include thorough sterilization of equipment, careful handling and disposal of needles and other sharp instruments and the wearing of protective clothing, such as gloves, when appropriate.

“Patients deserve accurate information and they deserve the best measures to protect them from disease transmission,” Health and Human Services Secretary Louis W. Sullivan said in a statement.

“In the overwhelming number of medical encounters, we simply don’t need to be worried about AIDS or hepatitis B transmission, and it is important for both patients and workers to understand that fact,” he added. “However, for more invasive procedures, these guidelines should be followed carefully.”

The guidelines recommend against mandatory testing of health care workers, although numerous groups have predicted that such restrictive policies ultimately will be adopted.

“We . . . applaud the explicit rejection of mandatory testing for all health care workers,” said Jeff Levi, director of government affairs for AIDS Action Council. “However, we fear that, in implementing these guidelines, the CDC’s version of voluntary testing of a limited number of health care workers will become mandatory testing of many.”

The only known instance of health professional-to-patient transmission occurred when a Florida dentist with AIDS apparently infected five patients.