HIV TRANSMISSION DURING INVASIVE RADIOLOGIC PROCEDURES - ESTIMATE BASED ON COMPUTER MODELING

OBJECTIVE. The primary purpose of this study was to estimate the risk of HIV transmission from physicians to patients during invasive radiol ogic procedures and to compare this estimate with those previously der ived for surgical procedures so that policy on possible practice restr ictions can be decided, The risk of HIV transmission from patient to p hysician, including cumulative career risk for interventional radiolog ists, was also estimated, MATERIALS AND METHODS. The risk of HIV trans mission from physician to patient and vice versa was estimated with co mputer 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 o f occupational infection was estimated with a computer simulation mode l, RESULTS. If the physician's HIV status is unknown, the risk of tran smission of HIV to a patient during a procedure is estimated to be 0.0 3 per million procedures (95% confidence interval, 0-3.8 per million p rocedures), If the physician is known to be HIV-positive, the risk of transmission to a patient is estimated to be 7.5 per million procedure s (95% confidence interval, 0-15.3 per million procedures), The estima ted 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 oc cupational HIV infection over 30 years is estimated to be 0.009-16%, C ONCLUSION. The estimated risk of HIV transmission from physician to pa tient during invasive radiologic procedures is so low that global prac tice 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 restrictio ns should be made on a case-by-case basis rather than a priori, The ri sk of HIV transmission from patient to physician is also low, but real , The cumulative career risk of occupational infection with HIV may va ry widely based on individual circumstances and the patient population served.