Ciesielski C, Marianos D, Ou C Y, Dumbaugh R, Witte J, Berkelman R, Gooch B, Myers G, Luo C C, Schochetman G
Centers for Disease Control, Atlanta, Georgia.
Ann Intern Med. 1992 May 15;116(10):798-805. doi: 10.7326/0003-4819-116-10-798.
To determine if patients of a dentist with the acquired immunodeficiency syndrome (AIDS) became infected with human immunodeficiency virus (HIV) during their dental care and, if so, to identify possible mechanisms of transmission.
Retrospective epidemiologic follow-up of the dentist, his office practice, and his former patients.
The practice of a dentist with AIDS in Florida.
A dentist with AIDS, his health care providers and employees, and former patients of the dentist, including eight HIV-infected patients.
Identification of risks for HIV transmission (if present), degree of genetic relatedness of the viruses, and identification of infection control and other office practices.
Five of the eight HIV-infected patients had no confirmed exposures to HIV other than the dental practice and were infected with HIV strains that were closely related to those of the dentist. Each of the five had invasive dental procedures, done by the dentist after he was diagnosed with AIDS. Four of these five patients shared visit days (P greater than 0.2). Breaches in infection control and other dental office practices to explain these transmissions could not be identified.
Although the specific incident that resulted in HIV transmission to these patients remains uncertain, the epidemiologic evidence supports direct dentist-to-patient transmission rather than a patient-to-patient route.
确定患有获得性免疫缺陷综合征（艾滋病）的牙医的患者在接受牙科治疗期间是否感染了人类免疫缺陷病毒（HIV），如果是，则确定可能的传播机制。
对该牙医、其诊所业务及其以前的患者进行回顾性流行病学随访。
佛罗里达州一名患有艾滋病的牙医的诊所。
一名患有艾滋病的牙医、他的医护人员和雇员，以及该牙医以前的患者，包括8名感染了HIV的患者。
确定HIV传播的风险（如果存在）、病毒的基因相关性程度，以及确定感染控制和其他诊所业务情况。
8名感染HIV的患者中有5名除了牙科治疗外没有确诊的HIV暴露史，并且感染的HIV毒株与该牙医的毒株密切相关。这5名患者每人都接受了侵入性牙科手术，由该牙医在被诊断出患有艾滋病后实施。这5名患者中有4名在同一天就诊（P>0.2）。无法确定感染控制和其他牙科诊所业务中的违规行为来解释这些传播情况。
虽然导致这些患者感染HIV的具体事件仍不确定，但流行病学证据支持牙医直接将病毒传播给患者，而非患者之间的传播途径。
