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1996-03-04
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Document 0560
DOCN M9640560
TI HIV transmission during invasive radiologic procedures: estimate based
on computer modeling.
DT 9604
AU Hansen ME; McIntire DD; Department of Radiology, University of Texas
Southwestern Medical; Center, Dallas 75235-8896, USA.
SO AJR Am J Roentgenol. 1996 Feb;166(2):263-7. Unique Identifier : AIDSLINE
MED/96143090
AB OBJECTIVE: The primary purpose of this study was to estimate the risk of
HIV transmission from physicians to patients during invasive radiologic
procedures and to compare this estimate with those previously derived
for surgical procedures so that policy on possible practice restrictions
can be decided. The risk of HIV transmission from patient to physician,
including cumulative career risk for interventional radiologists, was
also estimated. MATERIALS AND METHODS: The risk of HIV transmission from
physician to patient and vice versa was estimated with computer modeling
techniques, using available data on prevalence of HIV infection, rates
of injury during invasive radiologic procedures, and risk of viral
transmission after an exposure. Cumulative career risk of occupational
infection was estimated with a computer simulation model. RESULTS: If
the physician's HIV status is unknown, the risk of transmission of HIV
to a patient during a procedure is estimated to be 0.03 per million
procedures (95% confidence interval, 0-3.8 per million procedures). If
the physician is known to be HIV-positive, the risk of transmission to a
patient is estimated to be 7.5 per million procedures (95% confidence
interval, 0-15.3 per million procedures). The estimated risk of
transmission from patient to physician ranges from 0.03 to 7.5 per
million for a single procedure, and the cumulative risk of occupational
HIV infection over 30 years is estimated to be 0.009-16%. CONCLUSION:
The estimated risk of HIV transmission from physician to patient during
invasive radiologic procedures is so low that global practice
restrictions on HIV-infected interventional radiologists are not
warranted. As recommended by the American Medical Association and the
Centers for Disease Control, decisions on possible practice restrictions
should be made on a case-by-case basis rather than a priori. The risk of
HIV transmission from patient to physician is also low, but real. The
cumulative career risk of occupational infection with HIV may vary
widely based on individual circumstances and the patient population
served.
DE *Computer Simulation Disease Transmission,
Patient-to-Professional/*STATISTICS & NUMER DATA Disease Transmission,
Professional-to-Patient/*STATISTICS & NUMER DATA Human HIV
Infections/EPIDEMIOLOGY/*TRANSMISSION Occupational
Diseases/EPIDEMIOLOGY Occupational Exposure/STATISTICS & NUMER DATA
Prevalence *Radiology, Interventional Risk Assessment Time Factors
JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).