The logical editorial "Doctors and Patients and AIDS" {Dec. 8} should be commended. However, as a doctor, I know there are some technological advances that should change some of its considerations.

There is now an "instant" HIV antibody test (approved by the FDA) that can be finalized in about 15 minutes. Other such tests are in the FDA approval process. When I send a patient to a surgeon, the patient goes with an HIV test result. There is no good reason not to have done the test for the surgeon's and hospital personnel's protection. Any good emergency room should be equipped with such test kits, just as they are equipped for blood oxygens and other tests.

It is true, as the editorial states, that HIV antibody may not show up for some time after a person has been exposed. But, an HIV antigen test is available and may be positive before the antibody appears, so the test may be useful, although it is time-consuming and not cost effective in non-high-risk circumstances.

The more common need is to rapidly evaluate, during a patient visit, whether a healthy appearing person is at a high risk and in need of HIV testing. In addition to a patient history, which may not be available during some emergencies, there are several of the conventional blood count and chemistry tests that do help to identify those subjects that could benefit from HIV testing. (Blood globulin, platelets, white cell counts, liver function tests such as SGOT/SGPT are examples.) All of these tests can and should be done during a patient visit, particularly in an emergency room, if we are really serious about wanting to thwart HIV progress. They can all be done within 30 minutes.

The reports of transmission from physician to patient are another matter, and ethical consideration is needed. However, in evaluating some of the reported cases, it should be remembered that the natural course of HIV is 10 years or more. Further, symptoms generally do not appear during the first five years. Curiously, a number of the reported cases in which legal action has been taken appear to have had a much shorter disease onset-to-symptom course.

C. A. CACERES Washington