Associated Press - Thursday, December 1, 1994
Ted Anthony, Associated Press

The conclusions contrast sharply with earlier federal research into the practice of another dentist, Dr. David Acer, the only health professional ever known to have transmitted HIV to his patients.

The new study by the federal Centers for Disease Control and Prevention and the Florida Health Department used DNA sequencing to isolate the strain of HIV carried by the unidentified Miami dentist.

It found no evidence the dentist's HIV-positive patients contracted their infections from him because their virus' DNA did not match his.

The study, published in Thursday, rsday's issue of the Annals of Internal Medicine, also concluded the dentist's patients did not contract the virus from one another -- in effect, that unclean dental implements did not act as conduits.

"This follow-up helps put the Acer investigation in better perspective," said Dr. Harold W. Jaffe, the study's leader and director of the CDC's Division of HIV-AIDS.

"It tells us that the risk from dentist to patient is very low, and based on that low risk, we don't favor mandatory screening of health-care providers," Jaffe said.

Acer, of Jensen Beach, died in 1990 after infecting six patients, the CDC said -- including Kimberly Bergalis, who waged a crusade for mandatory testing of health-care workers before she died in December 1991.

The second dentist practiced in the Liberty City area of Miami for nearly 30 years and served a primarily indigent population with a high rate of reported AIDS cases.

He tested HIV-positive in June 1988 and died in a hospice in August 1991.

Of 6,474 patients who had records of receiving care from the dentist during his final five years of practice, 1,279 underwent HIV tests, and 24 tested positive. Four others were identified through other means.

According to the study, all but four of the 28 HIV-positive patients had potential behavioral risks. DNA sequencing of the viruses did not indicate the dentist's HIV, and the patients' were linked.

"If the dentist had been the source of infection to some of his patients, we would expect their viruses to look very similar," Jaffe said. "But instead, we found that each of the infected patients and the dentist had distinct strains, suggesting that each was infected independently."

Researchers, though, acknowledged dental instruments contaminated with blood or tissue could transmit HIV between patients. They also said their study was limited by the sample -- about 20 percent of all the dentist's patients.

Some AIDS experts said the new study could help quell fears that caused some people to question the entire dental profession after Bergalis' death.

"There might be a sort of momentary message that reinforces the good news that's been coming out of CDC," said Gerald Myers, director of the HIV Sequence Database and Analysis Project at Los Alamos National Laboratory. His quasigovernmental organization tracks different strains of HIV.

"On the other hand," he cautioned, "it doesn't mean that by the turn of the century, when the number of cases has doubled, that we won't see another case like the Acer case."

Robert Montgomery, who represented Bergalis and three other Acer patients, warned against false security. He said the study should not be used to oppose mandatory testing of health professionals.

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