Bloodborne HIV: Don't Get Stuck!

Patient in New York City infected via unidentified hospital procedure in 2017: A young heterosexual man with an HIV-negative partner and no injection drug use tested negative when admitted to hospital for chronic kidney disease. 99 days later he tested HIV-positive. Suspecting he was infected during hospital procedures, an investigation found 10 HIV-positive patient who were possible sources of contaminated hospital instruments. Only one of the 10 had an HIV sequence that matched the young man’s HIV sequence. They had been on the same ward one day during which they were both given skin-piercing treatments, and they received renal dialysis at the same facility though not on the same machine or the same day. The investigation was unable to identify the lapse in standard precautions that allowed HIV from one patient to infect another.

Anderson BJ et al. Investigation of presumptive HIV transmission associated with hospitalization using nucleotide sequence analysis – New York, 2017. MMWR Morb Mortal Wkly Rep 2020 Mar 13; 69:260. (https://doi.org/10.15585/mmwr.mm6910a2)

Dental patients infected, late 1980s: During 1990-92, the Centers for Disease Control and  Prevention (CDC) report an investigation of HIV infections among among dental patients in Florida. The investigation began when a woman with no identified risk found she was HIV-positive. She suspected she may have gotten HIV from her dentist, who was ill. The investigation tested circa 1,100 former patients of the suspected dentist. “Five of the eight HIV-infected patients [identified during the investigation] had no confirmed exposures to HIV other than the dental practice and were infected with HIV strains that were closely related to those of the dentist. Each of the five had invasive dental procedures, done by the dentist after he was diagnosed with AIDS. Four of these five patients shared visit days (P > 0.2). Breaches in infection control and other dental office practices to explain these transmissions could not be identified… Although the specific incident that resulted in HIV transmission to these patients remains uncertain, the epidemiologic evidence supports direct dentist-to-patient transmission rather than a patient-to-patient route.”

Ciesielski C, Marianos D, Ou C-Y, t al. Transmission of human immunodeficiency virus in a dental practice. Ann Int Med 1992; 116: 798-805. Available at: http://annals.org/aim/article-abstract/705514/transmission-human-immunodeficiency-virus-dental-practice?volume=116&issue=10&page=798 (accessed 4 January 2019).