Infectious disease screening of blood specimens collected post-mortem provides comparable results to pre-mortem specimens

Abstract

Serology assays for standard screening are optimised for use with sera collected from living adults and children. Because of potential changes in the vascular compartments after death, methods used for screening sera from cadaveric organ donors need to be validated before testing these specimens. Serum was separated from blood collected from cadaveric donors within 24 h of death and biochemical parameters measured to detect dilution of protein and haemolysis. In order to demonstrate if any inhibitors that might interfere with the assays were present, pre and post-mortem specimens were spiked with aliquots of human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), human T-cell Lymphotropic Virus (HTLV) and T. pallidum-positive sera. Comparison of serum from living subjects with serum obtained post-mortem showed that while the concentration of total protein decreased, concentrations of albumin, immunoglobulin G (IgG) and immunoglobulin M (IgM) remained unchanged. The degree of haemolysis, as measured by free haemoglobin, was within the limits accepted for the Architect analyser. Spiking of pre- and post-mortem specimens with aliquots of HIV, HCV, HBV, HTLV and T. pallidum-positive sera showed no statistical difference in the signal between pre-mortem and post-mortem results when tested on the Abbott Architect analyser. Positive results were obtained in each of a further nine subjects who had tested positive for HIV (n=1), HCV (n=8), HBV (n=1) on pre-mortem serological testing. These findings suggest that the sensitivity of the Abbott Architect serological screening tests is not significantly affected in specimens collected within 24 h of the cessation of life.

Ruptured Syphilitic Aneurysm: A Cause of Sudden Death in a Man with Human Immunodeficiency Coinfection

“…The latter would cause antigen–antibody binding and potentially cause false‐positive results; however, it would not affect the TPLA test, which is specific for treponemal antigens. Baleriola et al reported that no interference was detected in postmortem samples spiked with aliquots of T. pallidum ‐positive sera, with no significant differences between the results of premortem versus postmortem samples . Even if this previous study by Baleriola et al was restricted to samples collected within 24 h of postmortem, these results would support the reliability of the positive TPLA test results in our case.…”

Validation of Spiked Postmortem Blood Samples from Cornea Donors on the Abbott ARCHITECT and m2000 Systems for Viral Infections

“…Nonrelated ante- and postmortem clinical samples from cornea donors were analyzed by Baleriola et al [25]. Since data on the antemortem status of the cornea donors were unknown, a rate of possible false-negative results could not be determined.…”

Cost Savings Associated with Testing of Antibodies, Antigens, and Nucleic Acids for Diagnosis of Acute HIV Infection

“…Of the currently available assays, the FDA-approved Architect HIV Ag/Ab Combo (HIV Combo) assay (Abbott Diagnostics) has shown promise as a screening tool with a reported sensitivity of 100% and specificity of 95 to 99% when evaluated on p24 antigen and HIV antibody clinical standards as well as panels of fresh and frozen clinical specimens (2,25,30,33). The HIV Combo assay is a chemiluminescent magnetic microparticlebased immunoassay that uses recombinant antigens derived from the transmembrane proteins of HIV-1 groups M and O and HIV-2 for antibody detection and monoclonal anti-p24 for antigen detection (25).…”