ISOLATION OF HIV-1 FROM EXPERIMENTALLY CONTAMINATED MULTIDOSE LOCAL-ANESTHETIC VIALS

Objective: To investigate the hypothesis that HIV can be transmitted v ia contamination of multidose vials of local anaesthetic solution thro ugh reuse of needles and syringes. Design and setting: Laboratory stud y. (1) By experiments with multidose vials and disposable needles and syringes, we identified a sequence of events in which HIV could contam inate the anaesthetic solution. (2) Three anaesthetic solutions were c ontaminated with a laboratory strain of HIV and tested by viral cultur e and p24 enzyme immunoassay one, two and four hours later to see how long the virus remained active. Results: (1) Needles and syringes reta ined small volumes of fluid after use (mean, 25 mu L; in syringe alone , mean 16 mu L) which could be transferred to multidose vials of local anaesthetic. (2) 10 mL of anaesthetic solution contaminated with 8 mu L of HIV-infected solution (equivalent to 1% infected lymphocytes in vivo) contained active virus one hour later. In some settings, HIV cou ld be isolated four hours after exposure. Conclusion: When inadvertent ly contaminated with HIV, multidose solutions represent a potential so urce of transmissible virus.