Patient to Patient Transmission of HIV in a Surgeon's Private Rooms
In a letter to the Editor of The Lancet, (December 18th, 1993), Chant et al present details of what is described
as a "compelling" case for patient to patient transmission of HIV that occurred in November 1989 and involved
a male and four female surgical cases. In my view, the authors' conclusion cannot be made on the evidence
currently available or the evidence they present. The Lancet letter does no more than affirm that four women and
one man, who all attended a surgeon's rooms on the same day in November 1989, a day on which they were all
of unknown HIV serostatus, were later discovered to be HIV seropositive. The HIV seropositivity detected,
even if defined by the most stringent criteria available, cannot be regarded as proof of HIV infection or
transmission (see below), but rather, should be regarded as evidence either that the presence or development of
HIV antibodies is far more common in patients with skin lesions attending general surgeons than hitherto has
been suspected or documented, or that "highly unlikely" events, such as the attendance of 1 male and 4 females
all HIV seropositive, at the rooms of a surgeon on the same day, may occur. No scientific evidence has been
presented that provides "compelling evidence" for the transmission of a retrovirus.
