Human Immunodeficiency Virus (HIV)

Characteristics

Morphology Family: Retroviridae, Genus: Lentivirus. ssRNA, enveloped icosahedral nucleocapsid, of approximately 100 to 110 nm in diameter. Strains: HIV-1 and HIV-2. 
Growth Conditions Cell culture

Health Hazards

Host Range Humans
Modes of Transmission

In general, HIV is spread by close sexual contact or parenteral exposure through blood or blood products, including transfusion. Mother-child transmission can occur during pregnancy, delivery or breastfeeding.

Signs and Symptoms

Non-specific symptoms such as lymphadenopathy, anorexia, chronic diarrhea, weight loss, fever, and fatigue; opportunistic infections and malignant diseases without a known cause for immune deficiency.

Infectious Dose Unknown.
Incubation Period Variable

Medical Precautions/Treatment

Prophylaxis Post exposure prophylaxis is available.
Vaccines None
Treatment

Antiretroviral agents are available

Surveillance

Clinical follow-up and confirmation of diagnosis by serology or viral titers

Emory Requirements Report

Laboratory Hazards

Laboratory Acquired Infections (LAIs) Needle stick, contaminated sharp objects, direct contact of non-intact skin or mucous membranes with HIV-infected specimens/tissues.
Sources Blood; concentrated virus in a laboratory; visibly bloody fluid; other body fluids (semen, CSF, vaginal); unscreened or inadequately treated blood products. 

Supplemental References

Containment

BSL-2 Work involving clinical specimens and non-culture procedures
BSL-2+BSL-3 Practices or BSL-3 In vitro culture of competent virus (replication), and manipulation of concentrated virus. 
ABSL-2 Work with NHPs or other animals inoculated with HIV, and their specimens.

Spill Procedures

Small Notify others working in the lab. Allow aerosols to settle. Don appropriate PPE. Cover area of the spill with paper towels and apply an EPA registered disinfectant, working from the perimeter towards the center. Allow 30 minutes of contact time before disposal and cleanup of spill materials.
Large

Contact Emory’s Biosafety Officer (404-727-8863),
the EHSO Office (404-727-5922), or
The Spill Response Team (404-727-2888).

Exposure Procedures

Mucous membrane Flush eyes, mouth or nose for 15 minutes at eyewash station.
Other Exposures Wash area with soap and water for 15 minutes.
Reporting All work incidents (major or minor) must be reported to Occupational Injury Management. Complete an incident report using Self Service through Emory Peoplesoft (https://hrprod9.emory.edu)
Medical Followup 

7am-4pm (OIM): EUH (404-686-7941) EUHM (404-686-7106) WW (404-728-6431)

After Hours: OIM NP On Call 404-686-5500 PIC# 50464

Needle Stick (OIM): EUH (404-686-8587) EUHM (404-686-2352)

Yerkes: Maureen Thompson Office (404-727-8012) Cell (404-275-0963)

Viability

Disinfection Fresh 2% glutaraldehyde, 1% sodium hypochlorite
Inactivation HIV is inactivated by ultraviolet (UV) light, in close proximity; cell-free medium; pH higher or lower than 7.1; temperature higher than 60C for at least 30 min
Survival Outside Host Contaminated blood at room temperature for 42 days, and in blood and cerebrospinal fluid from autopsies for up to 11 days.

Personal Protective Equipment (PPE)

Minimum PPE Requirements At minimum, personnel are required to don gloves, closed toed shoes, lab coat, and appropriate face and eye protection prior to working with HIV. Additional PPE may be required depending on lab specific SOPs.
Additional Precautions

Extreme care must be taken to avoid spilling and/or splashing infected materials. HIV should be presumed to be in/on all equipment and devices coming in direct contact with infected materials.

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