World AIDS Day sees U-turn on HIV dentists

The ban on dentists and doctors with HIV carrying out procedures that might potentially lead to blood contamination could soon be lifted, the Department of Health (DH) announced today (Thursday) – World AIDS day.
A consultation into relaxing the restrictions placed on the work that can be undertaken by HIV positive healthcare workers was launched by Chief Medical Officer Dame Sally Davies, following a review by a group of leading experts.
It comes after a study of the evidence presented to the Chief Medical Officer concluded that the risk of transfer during any medical procedure was now negligible.
The Expert Advisory Group on AIDS, the UK Advisory Panel of Healthcare Workers Infected with Blood-borne Viruses and the Advisory Group on Hepatitis jointly examined evidence around the risk of HIV transmission from healthcare workers with HIV to patients.

They found that there have been no reported transmissions of HIV from healthcare workers even though there have been investigations involving 10,000 patients who were tested for HIV.

They also found that few other countries have such tight restrictions as the UK does – much of Europe along with Australia and America have removed the restriction.
Under the current system, healthcare workers diagnosed with HIV are not allowed to perform most surgical or dental procedures.
These restrictions will remain in place until the outcome of the consultation is decided.
Dento-legal expert, David Croser, of Dental Protection, and a campaigner for a change on the legislation, said in the summer: ‘Just recently, infection control standards in UK dental surgeries have been upgraded again with the universal adoption of HTM 01-05.
‘In addition, the introduction of bodies like CQC will provide a regular audit of those newly elevated infection control standards, thereby assuring the track record that has already been proven to successfully prevent transmission of blood-borne pathogens (in both directions, from patient to dentist and dentist to patient).’
Critics of the legislation have long suggested that the precautionary response adopted in the UK should be reviewed because of  such advances in the medical management of HIV disease and because of significant improvements in infection control standards.
The risk of HIV infection to any patient having the most invasive type of exposure prone procedure – such as open cardiac surgery – has been estimated as about one in five million, which is a similar level of risk to being struck and killed by lightning.

These risks can be reduced even further by effective antiretroviral drug therapy.
The DH will seek views from across the medical and dental professions as well as experts and members of the public.
A final decision is likely to be taken later next year.

Kevin Lewis, dental director of DPL, said: ‘Dental Protection has always championed the interests of members of the dental profession who are seen to be unfairly treated. The introduction of effective antiretroviral therapy in the 1990s combined with the absence of any proven transmission in the dental setting makes it totally unfair to continue to force members of the dental team to quit their chosen profession. Apart from the huge financial and personal consequences, these skilled clinicians are removed from the workforce that currently struggles to provide sufficient access to dental care for the growing UK population.

 ‘The changes to the regulations proposed by the Department of Health are a logical step that restores fairness for these members of the dental profession as well as safely managing the dental needs of the population.

 ‘Over the last 10 years, Dental Protection has led the way in this debate and the organisation will be actively contributing to the consultation process in order to protect the interests of its members and of the wider dental profession.’

World AIDS Day is held on 1 December each year and is an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died.
It was the first ever global health day and the first one was held in 1988.


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