Increasing number of patients admitted to Hospitals for other disorders are being found positive for HIV. HIV-positive patients and fully diagnosed AIDS cases will also be admitted in growing numbers to hospitals in future.
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This has necessitated proper understanding of HIV infection, AIDS and prevention and control of the spread of such infection by hospital personnel.
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Classified as a lipophile retrovirus, the AIDS virus is most readily comparable with the hepatitis-B virus. As with hepatitis-B virus, aerogenic transmission does not take place, but blood and secretions must be considered infectious.
When handling potentially infectious materials, the same hygienic precautions should be exercised as with hepatitis- B. Specifically, these are as follows:
i. Prevention of direct cutaneous contact with blood and other secretions
ii. Wearing of protective gloves
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iii. Wearing, where necessary, of protective goggles and facemasks
iv. Correct disposal of used needles and scalpels
v. Use of disposables
vi. Careful disinfection of hands, skin and contaminated instruments.
AIDS and Disinfection:
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Like all retroviruses outside the host organisms, the AIDS virus quickly loses its activity. Due to its sensitivity, the virus is very quickly destroyed by veridical disinfectants outside the body.
Twenty-five per cent ethyl alcohol, 2 per cent glutaraldehyde and 0.2 per cent sodium hypochlorite have shown to be adequate for disinfection of instruments and contaminated surfaces.
Disinfection of Hands:
In all problems associated with hygiene in the hospital, disinfection of hands is the most important step for prevention of infection, and this applies with AIDS also.
The safest, simplest method and gentlest to the skin is alcoholic rubs. They enable hands to be disinfected, independent of washbasin and water tap. A suitable disinfectant for prophylaxis rubbed in a small quantity (3 ml) for 1 minute is shown to be quite effective.
Disinfection of Instruments:
Used instruments must, in principle, be considered contaminated. Therefore, the rule to follow is as follows.
i. First disinfect, then clean and finally sterilise or make final disinfection.
ii. For endoscopes clean, disinfect, rinse with water.
Two per cent alkaline glutaraldehyde can achieve complete disinfection given sufficient contact time. Instrument parts containing rubber, plastic, fibre-optics and lenses can also be disinfected or sterilised by alkaline glutaraldehyde. It is necessary to thoroughly pre-clean and dries off instruments before placing in the solution, and completely immerses the portions of the instruments that contact the patient.