Protecting patients when their surgeon or dentist is infected with a blood-borne virus

The vast majority of surgeons and dentists infected with either hepatitis B or HIV do not transmit these infections to patients. When such transmission from health care provider to patients does occur, the precise mechanism of transmission usually remains enigmatic. Attempts to forestall these rare events have produced substantial debate as well as legislative and regulatory initiatives. The routine immunization of medical and dental students with hepatitis B vaccine will eventually eliminate surgeons and dentists as sources of this infection. Serological screening of surgeons and dentists for HIV infection has been considered impractical. Thus, emphasis has been placed on enhancing measures that reduce the risk of blood contact between health care provider and patient. These include developing safer techniques and procedures. When an infected surgeon or dentist is discovered, a review of their professional circumstances is undertaken. In the US many hepatitis B-infected persons are permitted to continue practice; most HIV-infected persons stop performing invasive procedures. Not completely reassured, some patients inquire of their dentist's or surgeon's HIV antibody status.