Detection of HIV-1 DNA in Needle/Syringes, Paraphernalia, and Washes from Shooting Galleries in Miami: A Preliminary Laboratory Report

Abstract

Shared use of injection equipment (needle/syringes), registering, booting, and backloading are practices among injection drug users (IDUs) that increase the risk for transmission of human immunodeficiency virus type 1 (HIV-1). The sharing of injection paraphernalia (including cookers and cottons) and washwater for rinsing used needle/syringes and dissolving drugs could be potential sources for secondary transmission of HIV-1. Laboratory rinses were made from needle/syringes, cottons, and cookers obtained from shooting galleries, and washwaters were obtained from shooting galleries in Miami. Three rinses were analyzed and antibodies to HIV-1 proteins were detected by using Western blot and HIV-1 DNA was detected by using nested polymerase chain reaction (PCR) specific for the gag and envelope genes of HIV-1. Antibodies to HIV-1 proteins were detected in 12 (52%) of 23 rinses from visibly contaminated needle/syringes, in three (18%) of 17 rinses from cottons, in three (14%) of 21 rinses from cookers, and in one (6%) of 17 washwaters. No antibodies were detected in laboratory rinses from visibly clean needles. Using nested PCR followed by Southern blot confirmation of the amplified targets, HIV-1 gag gene DNA was detected in 16 (84%) of 19 and envelope gene DNA in 17 (85%) of 20 laboratory rinses from visibly contaminated needle/syringes. We detected gag and envelope gene DNA, respectively, in three (27%) and four (36%) of 11 cottons, in six (46%) and seven (54%) of 13 cookers, and in five (38%) of 13 and in 10 (67%) of 15 washwaters from shooting galleries. No HIV-1 DNA was detected in laboratory rinses from visibly clean needles. These results indicate that HIV-1 might be present in contaminated cottons, cookers, and washwaters as well as in contaminated needle/syringes at shooting galleries. Reduction of risks of exposure to HIV-1 among IDUs may require modification of behaviors that are ancillary to the act of injection, such as the use of common cookers, cottons, and washwater.

Correlates of sharing injection equipment among male injecting drug users in Kathmandu, Nepal

“…Finally, our definition of risk did not include the sharing of injection equipment other than needles or syringes. As HIV is detectable in cookers, cotton, and rinse water (Shah, Shapshak, Rivers, Stewart, & Weatherby, 1996), the sharing of such equipment may place IDUs at additional risk. We recommend further studies among Nepalese IDUs that include these measurements.…”

Quantification of HIV-1 viral RNA in the blood in needles used for venous puncture in HIV-infected individuals

“…Using nested PCR, Shah et al 12 , detected viral particles of HIV-1 on a variety of objects visibly contaminated with blood, such as bits of cotton, spoons, lavatories, syringes, and needles collected at random from locales frequented by users of illicit injectable drugs.…”

“…The authors demonstrated that it is possible to isolate the virus at up to four weeks after contamination of the needles. Using nested PCR, Shah et al 12 , were able to isolate viral particles of HIV-1 on various objects visibly contaminated with blood that were collected from locales frequented by drug users 25 .…”

“…Epidemiological data show a strong correlation between the HIV-1 viral load of the index case and the risk of infectivity 10 . Among the various types of occupational exposure to blood and body fluids, needlestick with a hollowbore needle is the most frequently reported among nursing staff, accounting for more than 90% of the cases 1,[11][12][13][14] . The majority of the incidents of occupational HIV exposure among HCWs have involved needles 8,[15][16][17][18] .…”

Update and Overview of Practical Epidemiologic Aspects of HIV/AIDS among Injection Drug Users in the United States

“…33 Epidemiologic links between HIV and sharing drug solution and equipment have been documented but are not as strong as the links between HIV and syringe sharing. 27,29,[33][34][35][36][37] The potential for HIV transmission through drug solution and equipment is inferred from studies that show association between these behaviors and other blood-borne viruses; findings of HIV antibodies and HIV polymerase chain reaction gene products in used syringes, cotton, cookers, and water 38 ; and laboratory studies demonstrating potential for HIV transmission.…”