The potential for transmission of human immunodeficiency virus (HIV) type I has created serious concern for the continued clinical use of bone and soft-tissue allografts. Tissue brtiiks have employed 1 S 2 . 5 Mrad for sterilization of bone and tendon allografts, which, according to the current literature, approaches the level at which the tissue quality is adversely affected for iniplantation. Our working hypothesis was that gamma irradiation at increasing doses can proportionately inactivate HIV type 1. The objective of this study was to inactivate HIV type 1 by irradiation, as determined by its capacity to infect human T-lymphocytes and established cell lines in vitro. The replicative Competence of HIV type I was also assessed by the presence of reverse transcriptase activity, enzyme-linked inimunoadsorbent assay (ELISA), iniinunofluorescence assays for p24 viral core antigen, and the formation of syncytia induced by HIV type 1 in the cultures inoculated with irradiated virus. The results demonstrated the presence of active viral replication in previously noninfected cells in the supernatant samples that were exposed to as much a s 5.0 Mrad. The data for the 10-Mrad sample were indeterminate due to cellular damage. These data suggest that gamma irradiation (1.5-2.5 Mrad) does not constitute a virucidal dose for HIV type 1. Current technologies for screening have greatly improved, and the surgeon should rely on tissue bank screening procedures and other methods of preparation rather than sterilization by gamma radiation techniques in choosing allograft material.
Calcofluor white) has been found to be a useful, rapid chemofluorescent stain for detection of Pneumocystis carinii cysts in bronchoalveolar lavage samples. When compared with toluidine blue O and Giemsa stains on 45 specimens (22 positive and 23 negative), the sensitivity and specificity of the Cellufluor stain were 95 and 100%, respectively.
Using Pneumocystis carinii organisms propagated through three passages in embryonic chick epithelial lung cultures, specific antigens and antisera were prepared for use in counterimmunoelectrophoresis and indirect immunofluorescent antibody techniques. These methods proved to be specific and sensitive for the detection of P. carinii antigen and antibody, respectively, in sera, and were applied to the study of cancer patients with P. carinii pneumonitis (PCP), cancer patients without pneumonitis, and normal children. Antigenemia was detected in 95% of patients with PCP, in 15% of cancer patients without pneumonitis, and in none of the normal children tested.
In cross-sectional and longitudinal studies of normal infants and children, acquisition of serum antibody to P. carinii was demonstrated to occur progressively with increase in age. By 4 years of age two thirds of the normal children were found to have antibody to P. carinii in titers of 1:16 or greater. These studies indicate that subclinical P. carinii infection is highly prevalent in normal children, analogous to other opportunistic infections where active disease is manifest predominantly in the compromised host.
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