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Science 22 May 1992:
Vol. 256. no. 5060, pp. 1165 - 1171
DOI: 10.1126/science.256.5060.1165
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Articles

Molecular Epidemiology of HIV Transmission in a Dental Practice

Chin-Yih Ou 1, Carol A. Ciesielski 1, Gerald Myers 2, Claudiu I. Bandea 1, Chi-Cheng Luo 1, Bette T. M. Korber 2, James I. Mullins 3, Gerald Schochetman 1, Ruth L. Berkelman 1, A. Nikki Economou 4, John J. Witte 4, Lawrence J. Furman 5, Glen A. Satten 1, Kersti A. Maclnnes 2, James W. Curran 1, Harold W. Jaffe 1, Laboratory Investigation Group, and Epidemiologic Investigation Group

1 Division of HIV/AIDS, National Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333
2 Theoretical Division, Los Alamos National Laboratory, Los Alamos, NM 87545
3 Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305
4 Florida Department of Health and Rehabilitative Services, Tallahassee, FL 32399
5 Division of Oral Health, National Center for Prevention Services, Centers for Disease Control, Atlanta, GA 30333

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.


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