A consultation into relaxing the restrictions placed on the work that can be undertaken by HIV positive healthcare workers was launched today by Chief Medical Officer Dame Sally Davies, following a review by a group of leading experts.
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.
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.
The expert advisory groups concluded that the risk of HIV transmission from a healthcare worker who is undiagnosed and untreated is extremely low for the most invasive procedures such as open cardiac surgery. It is negligible from the least invasive procedures such as a local anaesthetic injection in dentistry.
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 consultation invites views from the medical community as well as the public on whether current restrictions should be maintained or how the expert group’s findings could be implemented effectively.
Chief Medical Officer Professor Dame Sally Davies said:
“Patient safety is always our top priority. Our knowledge and understanding and the treatment of HIV have all developed enormously over the last 25 years. It is right that we now consider our current guidelines to reflect what the science is telling us about the risk of HIV transmission from healthcare workers with HIV to patients.
“There are currently around 110 healthcare workers with HIV [in England] who might be affected by the current restrictions. We need to ensure that the guidelines and restrictions imposed are evidence-based and achieve a fair balance between patient safety and the rights and responsibilities of healthcare workers with HIV.
”This consultation will seek wide views on the expert advice and whether it should be accepted.”
Chairman of the Expert Advisory Group on AIDS, Professor Brian Gazzard said:
“I welcome this consultation. Our careful review of the evidence suggests that the current restrictions on healthcare workers with HIV are now out of step with evidence about the minimal risk of transmission of infection to patients and policies in most other countries.
“This risk can be reduced even further if the healthcare worker is taking effective drug therapy for HIV and being monitored by HIV and occupational health specialists. “
Sir Nick Partridge, Chief Executive of HIV and sexual health charity Terrence Higgins Trust, said:
"It's right to review these restrictions in the light of modern evidence.
We know far more now about HIV and its transmission than we did when these rules were made.
“We look forward to their reform, so that highly trained healthcare workers are no longer needlessly lost to the NHS."