Report Raises Questions About Dentist’s Role in HIV Infections

A new report released Wednesday cast doubt on whether a Florida dentist--accused in a highly publicized case of infecting five patients with the AIDS virus--actually was responsible for the transmission.

The report, published in the British journal Nature, fell far short, however, of proving that the dentist, Dr. David Acer, who has since died of AIDS, was not the source of the infection.

“We are not saying that the dentist did not infect the patients--we’re saying you really can’t prove it one way or the other,” said Ronald W. DeBry, an evolutionary biologist in Florida State University’s department of biological science.

“We are not saying that we can prove any other source of infection for any of the patients,” he added. “What we are saying is that you also cannot prove the dentist was the source.”

The case has been cited at the only example of transmission from an infected health professional to a patient since the AIDS epidemic began in 1981. There have been several dozen instances, however, in which health care workers have become infected through contact with the blood of a patient.

Officials from the federal Centers for Disease Control and Prevention, who conducted the initial investigation and have concluded that Acer was the source, dismissed the report, saying that it ignores substantial additional evidence that points to him.

The CDC investigation, among other things, pointed out that none of the five infected patients had any known high-risk behaviors that would have made them vulnerable to transmission.

“They are ignoring everything else in the investigation,” said Dr. Harold Jaffe, the CDC epidemiologist in charge of the investigation.

The Florida case ignited a national debate over whether health professionals infected with the human immunodeficiency virus should inform their patients--or even be allowed to practice.

The most famous of those patients, Kimberly Bergalis, became a symbol of the “innocent victim” of AIDS. Before her death from AIDS, she waged a relentless, sometimes bitter and ultimately unsuccessful campaign for mandatory HIV testing of health care workers.