Tympano-ossicular allografts and HIV transmission

Objective: To evaluate the potential risk of human immunodeficiency virus ( HIV) transmission by tympano-ossicular allografts by studying the efficacy of standard preservation techniques to eliminate the presence of proviral H IV-I DNA fragments in contaminated ossicles. Study Design: Randomized single-blind prospective study on the ossicles of HIV-1 patients. Material: Ossicles of five patients who had died of acquired immune deficie ncy syndrome (AIDS) (HIV infection) were taken within 6 hours postmortem an d allocated randomly to a treatment and nontreatment group. Liver and skin biopsies were taken as positive control specimens. Processing: The treatment group was processed with standard techniques (for maldehyde) for tympano-ossicular allograft preservation and the nontreatmen t group was only washed, dried, and stored in sterile tubes at -70 degrees without further processing. Main Outcome Measure: Proviral HIV-1 DNA was detected using polymerase chai n reaction amplification techniques. Results: No proviral HIV-1 DNA was detected in any of the treated ossicles, whereas three of Five sets of untreated ossicles were positive. The positi ve control specimens of all treated and nontreated sets were positive for p roviral HIV-1 DNA. Conclusions: These results suggest that the preservation technique for tymp ano-ossicular allografts is safe with regard to HIV-1 transmission.