[Possibilities for HIV inactivation in homologous bone transplants]

Recently, the availability of bone allografts has declined dramatically, due to the three-month HIV test which is often difficult to obtain. Accordingly, there is a search for methods to inactivate HIV in bone allografts without compromising the biologic quality of the grafts. Chemical substances require long exposure and desorption times, to ensure that no toxic agents remain within the bone before actual transplantation. X-ray inactivation leads to complete loss of any osteoinductive properties of the allografts, according to some authors. In addition, the high doses that are necessary are difficult to apply. Autoclaving has been practiced in some instances, but all experimental results and some more recent clinical observations warn that osteoinductive properties of the allografts are lost during the autoclaving process. Lower temperatures (56 degrees C) are sufficient to warrant inactivation of HIV, and some experimental results and preliminary clinical observations indicate that moderate heat treatment of bone allografts in a water bath may become a useful method for virus inactivation of bone allografts.