HIV-infected health care workers

Abstract

Escalation of the epidemic of HIV infection has led to anxiety over the possibility that HIV-infected health care workers may present a risk to their patients. This issue entered the public arena in the United Kingdom in November 1987, in the case X v. Y, when a High Court judge made permanent an injunction against a national newspaper preventing the disclosure of the names of two doctors with AIDS undergoing treatment at a London hospital.⁽¹⁾ The extremely low risk of transmission of HIV by an infected doctor was considered to be far outweighed by the dangers of breaching confidentiality for those found to be infected or at risk. Only if absolute confidentiality could be guaranteed would doctors come forward for testing and seek medical attention and counselling if they were found to be infected. There are three major aspects to consider in attempting to evaluate the evidence supporting the assumption that the risks are minute: the danger of transmitting HIV itself, the possibility of transmission of opportunistic infections and the possible risks to the patient if a medical practitioner should develop dementia as a result of HIV encephalopathy. Although the public may perceive that these risks are particularly worrying in the context of an infected medical practitioner, they must also be considered for any health care worker who has patient contact.