A letter recently received from Senggo Christian Hospital in Irian Jaya, raised various questions about the sterilisation of equipment to kill the HIV virus. The letter ends ‘...in the developing world, it isn’t much help to know that glutaraldehyde is best, when it is too expensive and hard to get.’
Here are a number of helpful points from Dr Victoria Wells of ECHO and Dr Monica Cheesbrough, which may be of use to those of you involved with sterilising equipment in small clinics where supplies of suitable disinfectant may be erratic or difficult to obtain. These chemicals will kill the HIV virus after soaking for 30 minutes.
- Glutaraldehyde 2%
- Rubbing alcohol 70%
- Polyvidone iodine 2%
- Surgical spirit 70%
- Chlorine solution 0.5%
- Hydrogen peroxide 6%
Lysol, Savlon and Dettol will not kill the HIV virus.
- Follow the recommended soaking time in disinfectant exactly. Do not remove equipment too soon. A recent problem is that many people are leaving instruments and needles too long - sometime for several hours - to make sure the HIV virus is killed. However, this has the effect of damaging the metal surface of instruments and needles - causing rapid wear and rusting.
- If no suitable chemical is available, rinse and then boil all instruments - in a covered pan - at a rolling boil for at least 20 minutes. Ideally, use an autoclave (see below). Remove instruments with sterile forceps and keep in a covered sterile tray.
- If none of these recommended chemicals are available, bleach will kill the HIV virus. However, bleach is supplied in a variety of concentrations and it is vital to know the strength of the bleach you are using. Also, bleach rapidly becomes ineffective in heat and strong light. For sterilising instruments and needles a 0.5% solution (100,000 ppm chlorine) is needed.
- ECHO can supply portable autoclaves for £200 to £300 anywhere in the world. They also supply a powder disinfectant - VIRKON - related to glutaraldehyde. 5kg costs about £35 to post. Recommended dilution is 50 gm per 5 litres water - so this is a huge quantity.
Ask for more information from...
ECHO, Ullswater Crescent, Coulsdon, Surrey, CR5 2HR, UK.
A new chemical will soon become widely available throughout the world - NaDCC. This is very stable in heat and sunlight, easy to use in tablet form and quickly kills the HIV virus. Look out for this in your own country.