From IEDs to AIDS? Detection of HIV in human corpses by rapid screening tests after suspected intentional transmission in terrorist attacks

Frickmann, Hagen; Wulff, Birgit; Loderstaedt, Ulrike; Hagen, Ralf Matthias; Sturm, Deborah; Polywka, Susanne

doi:10.1136/jramc-2013-000048

Cited by 8 publications

(7 citation statements)

References 34 publications

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…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. In contrast, Strong et al () stated that NAT could reliably detected HIV in post‐mortem samples; however, reliable results were only obtained after a 1:5 dilution of the samples.…”

Section: Resultsmentioning

confidence: 99%

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Human immunodeficiency virus in cadavers: A review

2019

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Millions of people are infected with human immunodeficiency virus (HIV); however, limited research focuses on post-mortem HIV detection. Post-mortem HIV testing is vital because medical records are not always available, and the HIV status can be unknown. The aims of this study were to review the available literature and determine the most efficient HIV test for post-mortem samples, the optimal tissue or bodily fluid to be tested, and the duration that HIV remains reliably detectable. A literature search was conducted using PubMed and Google Scholar. Terms were related to HIV (HIV detection, HIV testing, HIV prevalence) and deceased individuals (post-mortem, cadaver, deceased, organ donor). Inclusion criteria included English studies, or articles with at least an English abstract, while review articles were excluded. From this literature search, 43 studies were applicable. These studies most commonly used enzyme-linked immunosorbent assay and Western blot as screening and confirmation tests, respectively. As for the optimal tissue or bodily fluid, serum remained the golden standard, while testing skin seemed promising. HIV remains detectable in the body up to 58 days after death, although few studies tested samples after 48 h. Knowledge of the HIV status can be beneficial in the case of accidental exposure and can create a range of possible research opportunities on the effects of HIV in different organ systems. This review outlined several gaps in the current literature and future studies should investigate these gaps because this information can be relevant to numerous professions. Clin. Anat. 32:603-610, 2019.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Human immunodeficiency virus in cadavers: A review

2019

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“…Humanitarian aid missions in conflict areas with a high HCV burden are associated with an increased risk. In asymmetric military conflicts, there is the additional jeopardy of infection due to ballistic transmission via bone fragment implantation during suicide bombing 5. For example, in Afghanistan, HCV seroprevalence of 36.6% among injecting drug users11 provides an easily accessible source for the self-inoculation of potential suicide assassins with fresh, replicative virus-containing blood.…”

Section: Discussionmentioning

confidence: 99%

“…The material was subsequently transferred into labelled, empty 10 mL test tubes (Harre Co., Hannover, Germany) 4 5…”

Section: Methodsmentioning

confidence: 99%

Is rapid hepatitis C virus testing from corpses a screening option for index persons who have died after mass-casualty incidents in high-prevalence settings in the field?

Hagen

Wulff

Loderstaedt³

et al. 2013

J R Army Med Corps

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IntroductionWe tested a commercially available rapid hepatitis C virus (HCV) test assay for its potential use for analyses of corpses as a screening option for index persons who have died after mass-casualty incidents in high-prevalence settings in the field. Materials and methods 50 blood samples were drawn from 16 recently deceased confirmed HCV-positive patients whose corpses were stored at 4°C in the mortuary and were analysed at admission and up to 48 h post mortem by rapid serological testing using the ImmunoFlow HCV test (Core Diagnostics, Birmingham, UK) in comparison with automated serological assays and PCR. Samples from 50 HCV-negative corpses were also analysed. Results The blood of only four of the 16 HCV-positive corpses reacted clearly with the ImmunoFlow HCV test, while in five cases the result was only weakly reactive and three cases showed very weak reactivity. Four of the infected corpses showed initially negative results, three of which became very weakly reactive 48 h post mortem. 49 out of 50 samples (98%) from HCV-negative corpses tested negative. Discussion The rapid test system we investigated showed insufficient sensitivity regarding the identification of HCV positivity. Automated serological testing or PCR should be preferred if it is realistically available in the deployed military setting.

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“…Aware of their military inferiority in logistics and firepower compared with regular troops, such irregular forces might try to partially compensate for this disadvantage by nefarious and internationally proscribed tactics of warfare. We have recently discussed the practicality of amplifying the effects of suicide bombing by the transmission of blood-borne viruses 1. Medical services must be prepared to cope with the physical and psychological consequences of irregular attacks targeting any of the potential weaknesses of deployed troops.…”

Section: Introductionmentioning

confidence: 99%