An important and much-debated ethical issue is whether a healthcare worker who has contracted the HIV virus should be allowed to work with patients knowing that there is a risk of infection. Until now, there were no laws that regulated this issue in England.
The UK Department of Health announced last 14th of August that starting in April, physicians, dentists and other healthcare workers in the UK would be able to resume their clinical activity providing their antiretroviral treatment had managed to reduce their HIV viral load of their blood to undetectable levels, that their antiretroviral treatment be ongoing, and that these individuals register their status with the Department of Health to review their viral load every four months. The problem here is not whether they are infected or not, but whether they could infect others with the virus.
At any rate, even though the conditions established by the Department of Health are not met, the possibility of infection occurring between healthcare workers and their patients is very low. When the level of virus circulating in the infected subject is unknown, contagion will only occur once every five million instances of contact. There are four known cases of HIV infection between a health worker and a patient, all occurring abroad and before 2001; moreover, none of the four healthcare workers had undergone antiretroviral treatment.
Today in the UK it is estimated that there are about 110 health workers infected with the HIV virus that could benefit from this new law.
This new law seems to provide a solution to this serious ethical dilemma arising between a patient’s right to health and practices that discriminate against healthcare workers, who can now return to work without running the risk of infecting their patients (British Medical Journal 2013; 347: f 5146).