A decontamination and sterilization protocol employed during reuse of cardiac electrophysiology catheters inactivates human immunodeficiency virus.
OBJECTIVE
To assess the effect of a standard decontamination and sterilization protocol employed during reuse of cardiac electrophysiology (EP) catheters on human immunodeficiency virus (HIV).


METHODS
Public health viral research laboratory.


METHODS
Studies were performed on distal, electrode-containing segments of 40 EP catheters previously used in up to 10 clinical EP procedures. EP catheter segments were immersed for 1 hour in blood contaminated with a high titer of HIV. After air drying for 2 hours, subgroups of 8 EP catheters were subjected to either (1) no treatment, (2) washing in general purpose detergent, (3) washing in enzyme cleaner, (4) sterilization in ethylene oxide, or (5) the full protocol of sequential detergent-enzyme cleaner-ethylene oxide exposure. HIV infectivity after treatment was determined by measuring HIV RNA and, in cell culture studies, assessing HIV-induced cytopathic effects (CPEs) and supernatant HIV-specific p24 antigen content


RESULTS
With no treatment, all catheters had high HIV RNA levels associated with CPEs and high p24 antigen levels. After washing in detergent, 5 of 8 catheters had HIV RNA detected, but without CPEs or p24 antigen. HIV RNA was detected in all catheters after washing in enzyme cleaner, with CPEs and a high p24 antigen level in 1 of 8 catheters. HIV RNA, CPEs, and p24 antigen were absent after ethylene oxide. After the full protocol, HIV RNA levels were undetectable (n = 7) or low (n = 1), without evidence of CPEs or p24 antigen.


CONCLUSIONS
Appropriate decontamination and sterilization of EP catheters during reuse is highly effective in inactivating HIV.
Druce
Julian D
JD
Victorian Infectious Diseases Reference Laboratory, North Melbourne, Australia.
Russell
Jessica S
JS
Birch
Christopher J
CJ
Yates
Lynette A
LA
Harper
Richard W
RW
Smolich
Joseph J
JJ
D000956:Antigens, Viral / Q000032:analysis; D006328:Cardiac Catheterization / Q000295:instrumentation*; D004202:Disinfectants; D004566:Electrodes; D004594:Electrophysiology; D004866:Equipment Contamination; D017743:Equipment Reuse; D005027:Ethylene Oxide; D016655:HIV Core Protein p24 / Q000032:analysis; D015497:HIV-1 / Q000187:drug effects* / Q000472:pathogenicity*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D012367:RNA, Viral / Q000032:analysis; D013242:Sterilization / Q000379:methods*
D000956:Antigens, Viral; D004202:Disinfectants; D016655:HIV Core Protein p24; D012367:RNA, Viral; D005027:Ethylene Oxide