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October 6, 1993

HIV-Infected Health Care Workers: Risk to Patients

JAMA. 1993;270(13):1545. doi:10.1001/jama.1993.03510130051021

To the Editor.  —The look-back studies on clients of two human immunodeficiency virus (HIV)-1—positive surgeons1,2 and one dentist3 published in JAMA revealed no statistical evidence to confirm transmission of the acquired immunodeficiency syndrome (AIDS) during invasive operative procedures wherein universal precautions were heeded. The Editorial4 suggested hepatitis B virus (HBV) and human immunodeficiency virus (HIV) transmission to clients tends to occur in unexplained clusters. Although transmission risks seem low, most clients don't consider themselves statistics. Many would like to know how a Florida dentist with AIDS, although contemporarily compliant with recommended precautions, actually infected a cluster of six office clients with his own DNA-fingerprinted strain of proviral DNA during the 2 years prior to his retirement (May 31, 1990) and death resulting from AIDS (September 3, 1990).5The only invasive procedure common to all his HIV-infected clients was use of a standard cartridge-aspirating syringe (CAS) for giving