HIV-1 SURVIVAL KINETICS IN PERITONEAL-DIALYSIS EFFLUENT

Viable and potentially infectious HIV-1 has been recovered from the pe ritoneal dialysis effluent (PDE) of patients with end-stage renal dise ase (ESRD) who are infected with the human immunodeficiency virus (HIV ). No information had previously been available as to how long HIV-1 c ould survive in this environment, and no data were available as to how long HIV-1 could survive on peritoneal dialysis exchange tubing (PDET ). Therefore, this study was designed to answer these questions. HIV-1 Mn was added to PDE and allowed to incubate at room temperature for 0 to 14 days. Following centrifugation, the cellular component of the P DE mixture was placed in co-culture with peripheral blood mononuclear cells (PBMC) from HIV negative donors. Aliquots from the co-cultures w ere removed after 14 days and assayed for the HIV-1-P24 antigen. High levels of HIV P24 antigen were recovered up to and including seven day s of room temperature incubation. HIV could not be recovered from PDE that had been incubated at room temperature for 10 to 14 days. Ten mil liters of HIV-PDE mixture was placed within PDET and incubated at room temperature for 10 minutes. The solution was then removed by gravity drainage. After drying times of 0 to 168 hours, the tubing was hushed with HIV culture medium and placed in co-culture with PBMCs from HIV n egative donors. The culture supernatant was assayed for the HIV-1 P24 antigen as a marker of viral replication. High levels of HIV-1 P24 ant igen were recovered from the PDET wash for up to and including 48 hour s of drying time. No viable virus could be detected for drying times o f between 72 and 168 hours. To determine if common disinfectants found in the dialysis unit could inactivate HIV, dilutions of Amukin (TM) 5 0% and household bleach were prepared at final concentrations ranging from 1:32 to 1:2048. These disinfectant solutions were incubated with PDE containing HIV for 10 minutes. The cellular fraction of the PDE wa s isolated by centrifugation, washed, and placed in co-cultures with p eripheral blood mononuclear cells. HIV P24 antigen levels were assayed every three days for 28 days. Amukin (TM) 50% and a 10% household ble ach solution were effective in killing HIV in PDE at dilutions up to a nd including 1:512. These results indicate that HIV can survive in PDE at room temperature for up to seven days. HIV can survive on peritone al dialysis exchange tubing for up to 48 hours. Final dilutions of 1:5 12 Amukin (TM) 50% and 10% household bleach, after 10 minutes of expos ure, are effective viricidal agents in disinfecting PDE.