Gastrointestinal endoscopy in patients with acquired immune deficiency syndrome: an evaluation of current practices

To determine attitudes and practices associated with gastrointestinal endoscopy in patients with acquired immune deficiency syndrome (AIDS), we surveyed the chiefs of gastroenterology at 196 medical centers in the United States. The response rate was 61% overall and 100% from New York and San Francisco. Our results revealed a broad spectrum of perceived risk and precautions. Seventy-three percent of respondents believed that endoscopy places personnel at risk for contracting AIDS. At 35% of institutions endoscopic procedures are exclusively or frequently performed at the bedside of the patient with AIDS. At 46% of institutions procedures on patients with AIDS are performed with instruments used only in these patients. Endoscopic equipment used in patients with AIDS is gas sterilized at 85% of institutions. One third of respondents noted reluctance of personnel to participate in endoscopy for patients with AIDS. Reluctance was related to the respondent's perception of risk and did not differ among nurses, fellows, attendings, and gastrointestinal assistants. These data indicate that concern regarding transmission of the AIDS virus during endoscopy has resulted in costly and inefficient endoscopic practices.