Recommendations for Preventing Possible Trans­mission of Human T-Lymphotropic Virus Type Ill/ Lymphadenopathy-Associated Virus from Tears

Clayton, A.J.

Rosner, Bruce

English

Waterloo Library Journal Publishing Service (University of Waterloo, Canada)

alcohol and hydrogen peroxide (H202). There is currently available a contact lens cleaning solution which contains 20% mg./ml. isopropyl alcoho1.10Several (H202) systems are on the Canadian market for use with gas permeable rigid and hydrophilic lenses. H202 is an effective cell killing agent due to its strong oxidative potential. Free radical species (eg. hydroxyl ion) are generated under certain conditions and it is the hydroxyl radical that destroys the target cell. The hydroxyl radical will react with any group of phospholipids, proteins, or carbohydrates which will then undergo oxidative degradation. Three percent H202 has been shown to be effective against a wide variety of micro­organisms, including the herpes simplex virus. (HSV-1) It appears that using a combination of an isopropyl alcohol cleaner and H202 (3%) for 2 hours would result in the destruction of the HTLV Ill virus. However, this is still to be proven. An ethylene oxide sterilizing system should also be effective but the residue has a vesicant action and would be difficult to move from contact lenses. In conclusion, it appears that there is a remote possibility of infection with HTLV Ill via the tears of affected individuals in the use of tonometers and contact lenses. Practitioners should be aware of the risks involved and take appropriate measures to eliminate them as far as possible. It is the responsibility of the doctor to ensure effective disinfection of the devices used in practice. The patient should question, and be assured, to his/her satisfaction. Apparently it is the practice of some dispensers of contact lenses to accept the return of such lenses if the patient is not satisfied. Returned lenses may later be applied to the eyes of other patients. Patients should be warned of the attendant dangers inherent in such practices, especially if effective disinfection procedures are not in use. Although the risk of AIDS infection through the use of contact lenses has not been demonstrated, it would benefit us all to keep it that way by taking the appropriate precautions. References 1. Barre Sinoussi F. et al. Isolation of a T-Lymphotropic retro­virus from a patient at risk for acquired immune deficiency syndrome (AIDS) Science 1983, 220; 868-71.2. Lee. TH. et al. Acquired Immune Deficiency Syndrome. Proc. Nat Acad Sci (USA) 1984, 81; 75-79.3. Fujikawa LS, Salahuddin SZ, Palestine AG, et al. Isolation ofhuman T-cell leukimia/lymphotropic virus type 111 (HTLV-111) from the tears of a patient with acquired immune deficiencysyndrome (AIDS). Lancet (in press).Milogen: Substance or agent capable of inducing mitodic activity in an otherwise dormant cell. Antigen: Substance or agent capable of inducing antibody formation and of reacting specifically with antibodies produced. September /septembre 1985 4. Barin F. et al. Virus envelope protein of HTLV 111 representsmajor target antigen for antibodies in AIDS patients. Science1985, 228; 1094-6.5. Allan JS. Major glycoprotein antigens that induce antibodies in AIDS patients are encoded by HTLV 111. Science 1985, 228; 1091-3.6. Siegel RL, Fox RW. A longitudinal study of a patient with acquired immune deficiency syndrome using T-cell subsetanalysis. Adv Exp Med Biol 1983 166; 295-303.7. Hirsch MS, Warmser GP, Schooly RT. Risk of nosocomialinfection with the human T-cell lymphotropic virus Ill.(HTLV 111) N Engl J Med 1985, 312; 1-4.8. Martin LS, McDougal JS, Loskoski SL. Disinfection and inactivations of the human T lymphotropic virus type111/lymphadenopathy associated virus. J Infect Dis. 1985,152; 400-3.9. Allansmith M. The Eye and Immunology 1982 C.V. Mosby St. Louis Missouri. 10. Miraflow - Personal communication J. Krezonowski and corporate data. Coopervision, Mountainview, California. Recommendations for Preventing Possible Transmission of Al OS from Tears Dr. A. J. Clayton, MB, ChB, DPH, MFCM, FRCP(C), Director General of Health and Welfare Canada Laboratory Center for Disease Control/ Ottawa, has transmitted to the Canadian Associa­tion of Optometrists' National Office on August 30th, 1985 at 2:15 p.m., the following enclosed recom­mendations telexed earlier by the U.S. Center for Disease Control (CDC) in Atlanta. Dr. Bruce Rosner, President of the Canadian Association of Optometrists, requested immediate circulation of this information to every optometrist in Canada because of its importance to optometrists and their patients. Recommendations for Preventing Possible Trans­mission of Human T-Lymphotropic Virus Type Ill/ Lymphadenopathy-Associated Virus from Tears. Human T-lymphotropic virus type I11/lymphade­nopathy-associated virus (HTLV-III/LAV), the etio­logic agent of acquired immunodeficiency syn­drome (AIDS), has been found in various body fluids, including blood, semen and saliva. Recently, scientists at the National Institutes of Health isolated the virus from the tears of an AIDS patient (1). The patient, a 33-year-old woman with a history of Pneumocystis carfnii pneumonia and disseminated mycobacterium avium-intracellulare infection, had no ocular complaints, and her eye examination was normal. Of the tear samples obtained from six other patients with AIDS or related conditions, three showed equivocal! culture results, and three were culture-negative. The following precautions are judged suitable to prevent spread of HTLV-III/LAV and other microbial pathogens that might be present in tears. They do not apply to the procedures used by individuals in 103 

Recommendations for Preventing Possible Transmission of Al OS from Tears

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Recommendations for Preventing Possible Transmission of Al OS from Tears

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