Molecular Epidemiology of HIV Transmission in a Dental Practice

Human immunodeficiency virus type 1 (HIV-1) transmission from infected patients to health-care workers has been well documented, but transmission from an infected healthcare worker to a patient has not been reported. After identification of an acquired immunodeficiency syndrome (AIDS) patient who ha...

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Published in:	Science (American Association for the Advancement of Science) Vol. 256; no. 5060; pp. 1165 - 1171
Main Authors:	Ou, Chin-Yih, Ciesielski, Carol A., Myers, Gerald, Bandea, Claudiu I., Luo, Chi-Cheng, Bette T. M. Korber, Mullins, James I., Schochetman, Gerald, Berkelman, Ruth L., Economou, A. Nikki, Witte, John J., Furman, Lawrence J., Satten, Glen A., MacInnes, Kersti A., Curran, James W., Jaffe, Harold W., Laboratory Investigation Group, Epidemiologic Investigation Group
Format:	Journal Article
Language:	English
Published:	Washington, DC American Society for the Advancement of Science 22-05-1992 American Association for the Advancement of Science The American Association for the Advancement of Science
Subjects:	Acquired immune deficiency syndrome Acquired Immunodeficiency Syndrome (AIDS) Acquired Immunodeficiency Syndrome - blood Acquired Immunodeficiency Syndrome - microbiology Acquired Immunodeficiency Syndrome - transmission AIDS AIDS/HIV Amino Acid Sequence Amino acids Base Sequence Biological and medical sciences Dental care Dentistry Dentists Disease transmission Diseases DNA, Viral - blood DNA, Viral - genetics DNA, Viral - isolation & purification Drug Use Epidemiology Female Florida Genetic aspects Genetic Variation Genetics HIV HIV (Viruses) HIV infection HIV infections HIV Infections - microbiology HIV Infections - transmission HIV-1 - genetics HIV-1 - isolation & purification human immunodeficiency virus 1 Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Male Medical research Medical sciences Molecular genetics Molecular Sequence Data Molecules Monocytes - physiology Oligodeoxyribonucleotides Patients Phylogeny Public health dentistry Records (Forms) Sequence Homology, Nucleic Acid Signatures Viral Envelope Proteins - genetics Viruses Florida Infection Human Immunopathology Viral disease Risk factor AIDS Hemopathy Dentistry Epidemiology Public health
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Summary:	Human immunodeficiency virus type 1 (HIV-1) transmission from infected patients to health-care workers has been well documented, but transmission from an infected healthcare worker to a patient has not been reported. After identification of an acquired immunodeficiency syndrome (AIDS) patient who had no known risk factors for HIV infection but who had undergone an invasive procedure performed by a dentist with AIDS, six other patients of this dentist were found to be HIV-infected. Molecular biologic studies were conducted to complement the epidemiologic investigation. Portions of the HIV proviral envelope gene from each of the seven patients, the dentist, and 35 HIV-infected persons from the local geographic area were amplified by polymerase chain reaction and sequenced. Three separate comparative genetic analyses-genetic distance measurements, phylogenetic tree analysis, and amino acid signature pattern analysis-showed that the viruses from the dentist and five dental patients were closely related. These data, together with the epidemiologic investigation, indicated that these patients became infected with HIV while receiving care from a dentist with AIDS.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Feature-3 ObjectType-Commentary-1
ISSN:	0036-8075 1095-9203
DOI:	10.1126/science.256.5060.1165