I had rectal surgery three weeks ago and I’m concerned with HIV transmission from surgeon, nurse, surgical team to myself as the patient. I have no reason to believe that this could have occurred. 

I do realize a risk is involved with any surgery. I’ve looked at the statement from 2004 from the Board of Surgeons of just how extremely rare it is for a patient to get HIV from surgery with data on this in America. I’ve looked at CDC’s estimate of 2.4 to 24 episodes of transmission to patient per million operations with surgery. I’ve looked for cases and can find very, very little. Yet, my anxiety gets the best of me and remain concerned. 

Last week I had a very mild cold with slight sore throat with duration of 4 days and prior limited night sweats a few days before, a headache and a couple canker sores a few days before onset of slight cold. I did not feel feverish, yet did not take temperature. No rash, no  classic symptoms of ARS. All of this does not appear consistent with ARS symptoms as it wasn’t flu like or even heavy cold like, would I be correct in that assessment of this not being consistent with ARS symptoms? 

I do intend to still get tested at the 4 week mark to ensure no transmission occurred to me during surgery. Yes, I’m entirely fearful of HIV with knowing my status of being HIV negative prior to surgery and with no true risk ever and most would not give concern to a surgery risk. I realize irrational with this, but always best to be safe. 

Can you tell me if having surgery, from your experience, is truly anything to be concerned over as a risk? 

Also, at the 3 week mark, if I were to test now with 4th gen test, how accurate would that be, 90%, 95%?  I believe the combined risk factor from surgery of being so rare (from what I’ve read yet would be interested in hearing your expertise on that potential risk) and a negative combo test at 4 weeks would be conclusive. Would you agree with that? Would testing now at 3 weeks or 4 weeks, combined with the very rare risk from surgery be conclusive to rest the topic? 

Would be most appreciated if you can advise on these questions…

Thank you!

First reply after reading only the first couple lines of your question:  Nobody in the world is known to have caught HIV from having a medical procedure, except for some patients of a dentist in the US many years ago. The most likely explanation of those events was intentional injection of his patients with his own blood, although the dentist died of AIDS before evidence could be conclusive and there was no trial. But that is the generally accepted explanation. As far as I know, no medical provider or procedure has ever been implicated in accidental HIV transmission to a patient.  You won't the first such case.

Looking at the figures you cite about such risks, they remain hypothetical -- calcuation of potential risk, not actual cases to my knowledge. And even the figures you cite are so low they should be considered zero for all practical purposes. I also agree your symptoms are not typical for ARS.

Accordingly, I do not recommend any testing for HIV in this situation. Of course you are free to be tested if a negative result would help reassure you. I understand that negative tests sometimes are more reassuring than professional opinion based on probabilities and statistics, no matter how expert the source. If I were in your situation, I certainly would not be tested (and I've had 4 major surgical procedures in the past 3 years and it didn't enter my mind to have an HIV test, even though I had various symptoms during my recovery period that in theory could have been due to ARS). But if you decide to be tested, don't do it at 3 weeks, when testing will be only about 90% conclusive. Wait 4 weeks (98% conclusive) or 6 weeks (100%) (these figures are for the antigen-antibody, i.e. "duo" or "4th generation" HIV tests).

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Dr Handsfield,

Thank you so much for your reply. That's tremendously reassuring and relieves all concerns. Such risk indeed appears to be simply hypothetical and not something that truly occurs. I also realize the medical community takes great caution with all patients too.

Hearing your insight on this, has truly taken away any anxiety. Simply for peace of mind; I will go ahead and get tested at the 4 week or 6 week interval, but I am confident that it will come back as non-reactive/negative. I realize testing is truly not necessary ( it was the slight unwell symptoms that garnered my attention yet they didn't seem to fit for ARS and you have identified that too) and most wouldn't test with surgery being virtually no risk for all practical purposes, yet just  solely for 100% peace of mind I'll test with realizing it will indeed come back as non-reactive.  Again, thank you so much, you've incredibly eased my mind on this, much appreciated!