Education And Debate

Management of HIV infected health care workers: lessons from three cases

BMJ 1996; 312 doi: (Published 04 May 1996) Cite this as: BMJ 1996;312:1150
  1. Jill Pell, senior registrara,
  2. Laurence Gruer, HIV and addictions coordinatora,
  3. Peter Christie, consultant epidemiologistb,
  4. David Goldberg, deputy director and consultant epidemiologistb
  1. a Department of Public Health, Greater Glasgow Health Board, Glasgow G1 1ET
  2. b Scottish Centre for Infection and Environmental Health, Ruchill Hospital, Glasgow J20 9NB
  1. Correspondence to: Dr Pell.
  • Accepted 29 February 1996

Three cases in which doctors in Glasgow were diagnosed as having HIV infection were all handled differently in relation to telling patients and the media. In the first patients were not told because the doctor had been doing administrative work and there was thought to be no risk to patients; although the media did report the case, it accepted the assurances given. In the second case, where a doctor had done many jobs in different specialities and places, the media identified the doctor before most patients had been informed: most calls to the helpline subsequently set up by the health authority were from patients who had not been treated by this doctor. This episode, however, allowed the incident team to be prepared for the next case, enabling the helpline to be established swiftly. In this case the doctor voluntarily identified himself, and this served to allay public fears and reduce the number of inappropriate calls to the helpline.

The risk of transmission of HIV from an infected health care worker to a patient lies between 1 in 4000 and 1 in 40000.1 HIV antibody tests have been performed on more than 22000 patients treated by infected health care workers.2 3 Although more than 100 patients tested positive, in only one incident was the health care worker, a dentist, implicated as the possible source of infection.2 3 The United Kingdom guidelines on the management of HIV infected health care workers encompass three main principles: a duty to protect patients, a duty of confidentiality towards infected health care workers, and the concept that the risk of HIV transmission is restricted to certain “exposure prone” procedures from which infected staff should refrain (see box).4 5 There have been three recent incidents in Scotland involving HIV infected doctors, all in …

View Full Text

Log in

Log in through your institution


* For online subscription