Detection of human immunodeficiency virus, hepatitis C virus, and hepatitis B virus in postmortem blood specimens using infectious disease assays licensed for cadaveric donor screening

Abstract

Licensed donor screening tests were positive on postmortem specimens obtained within 24 hours of death from individuals dying with HIV, HCV, and/or HBV, and were able to detect presence of the virus. The use of multiple tests (including antibody and direct viral detection methods) is necessary to adequately evaluate donors.

Human immunodeficiency virus in cadavers: A review

“…Most studies used an EIA or ELISA as a screening test, and Western blot as the confirmation test. Several studies stated that EIA and ELISA gave reliable results (Pepose et al ; Cavanaugh and King ; Leshchinskaia and Smol'skaia ; Karhunen et al ; Essary et al ; Schor et al ; Cattaneo et al ; Padley et al ; Edler et al ; Wilkemeyer et al ; Greenwald et al ), while some studies observed a false positive rate of 0.8% (Wilkemeyer et al ) and 6.7% (Heim et al ). Similarly, Western blot was found to reliably detect HIV in post‐mortem tissue (Cavanaugh and King ; Karhunen et al ; Essary et al ; Schor et al ).…”

“…Several studies (Padley et al ; Gubbe et al ; Meyer et al ) praised the ability of NAT to reliably detect HIV in post‐mortem samples; however, some studies reported contrasting results (Essary et al ; Strong et al ; Eriksen et al ; Frickmann et al ; Greenwald et al ). Eriksen et al () compared ante‐mortem and post‐mortem results and NAT gave false negative results in 50.0% of cases.…”

“…Eriksen et al () compared ante‐mortem and post‐mortem results and NAT gave false negative results in 50.0% of cases. Correspondingly, Greenwald et al () compared EIA and NAT from individuals with a known history of HIV; NAT only detected HIV in 50.0% of the samples, while EIA detected HIV in 97.9%. Frickmann et al () found that NAT amplification was inhibited by post‐mortem serum, and the RNA copy number was diverse.…”

“…One of the few assays that have been validated includes the Abbot PRISM® HIV Ag/Ab Combo, which is a chemiluminescent immunoassay (Victer et al ). Additionally, using more than one type of test would be beneficial (Barbara et al ; Greenwald et al ). If there is a sufficient quantity of the sample, samples should be tested more than once.…”

Serological testing on the ADVIA Centaur system for human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in specimens from deceased and living individuals demonstrates equivalent resultsƚ

“…Notably, combining serology with nucleic acid testing (to cover the serological window) increased the positivity to 97%. 21 In another study by Baleriola et al, all nine pre-mortem HIV and HCV positive results…”