HIV-2 cultured from blood 16 days after death

Human immunodeficiency virus in cadavers: A review

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. © 2019 Wiley Periodicals, Inc.

Medical examiners and Crimean-Congo hemorrhagic fever contamination risk

Crimean-Congo Hemorrhagic Fever (CCHF) is an acute zoonotic infection caused by the CCHF virus. The viruses' activity peaks during April and May with a mortality rate of 3-30%. Transmission of the virus to human occurs through tick bites or exposure to infected animals' tissues or blood. The major at-risk group includes farmers living in endemic areas. Health-care workers are the second most affected group. Virus has shown up in a diverse geographic area which includes Middle East, Asia, Africa and Eastern Europe and is considered one of the most wide-spread tick borne infections. The most recent cases are from Iran and Turkey. This article represents autopsy results of four CCHF infected cases in 2011 and 2012, in Ankara, Turkey.

Detection of hepatitis C virus antibodies and RNA among medicolegal autopsy cases in Northern France

Forensic medical personnel are at risk of exposure to blood-borne viruses including hepatitis C virus (HCV). The aim of this study was to determine prevalence of HCV markers among a cadaver population at the medicolegal institute in Lille. Seventy-seven consecutive cadavers were screened for antibodies to HCV and for HCV RNA. Positive results were confirmed by an immunoblot assay. Fifty-three cadavers had a histopathologic study. Anti-HCV was detected in 13 (16.9%) and accompanied by HCV RNA in 7 (9%) cases. The rate of HCV RNA detection among seropositive cases was 53.8%. Five cases had histopathologic lesions suggestive of hepatitis. This is the first HCV RNA screening in forensic cadavers. The results highlight the high prevalence rate of HCV cases in medicolegal practice in Lille. All forensic specimens should be treated as potentially infectious and universal precautions should be taken.

Biosafety considerations for autopsy

An autopsy may subject prosectors and others to a wide variety of infectious agents, including bloodborne and aerosolized pathogens such as human immunodeficiency virus, hepatitis B and C viruses, and Mycobacterium tuberculosis. Other hazards include toxic chemicals (e.g., formalin, cyanide, and organophosphates) and radiation from radionuclides used for patient therapy and diagnosis. These risks can be substantially mitigated through proper assessment, personal protective equipment, appropriate autopsy procedures, and facility design.

Bloodborne viruses in forensic medical practice in South Africa

Health care workers are at risk of exposure to bloodborne viruses including human immunodeficiency virus types 1 and 2 (HIV-1 and -2), hepatitis B virus (HBV) and hepatitis C virus (HCV). However, limited data is available regarding these risks to forensic medical personnel who are exposed daily to large numbers of severely traumatized bodies in South Africa, a country that has an existing and growing HIV epidemic and a high HBV seroprevalence. Because no specific prescriptions ensuring occupational safety in this regard exist for forensic medical personnel in South Africa, the prevalence of bloodborne viruses within this setting must be determined. Blood was taken randomly from 263 bodies examined at the Medicolegal Laboratory in Pretoria. Serologic tests to detect antibodies to HIV, HCV, and human T-cell lymphotropic virus types I and II (HTLV-I and -II) and to detect the presence of HBV surface antigen (HBsAg) were performed and positive results confirmed using conventional serologic assays. Serologic tests detected at least one of the four bloodborne viruses in 21% of cases. The overall seroprevalence for HIV-1/2 was 11%, rising to 19% in the sexually active reproductive age group (15 - 49 years). The HBsAg prevalence overall was 8%, rising to 9% in sexually active reproductive individuals. There was a low overall HCV seroprevalence of 1% and an even lower HTLV-I/II seroprevalence of 0.01%. Forensic medical personnel in South Africa are therefore at risk of exposure to bloodborne viral pathogens in, on average, 1 of 5 bodies autopsied. This risk is compounded by the high daily workload, traumatized state of many of the bodies, and adverse working conditions. It is imperative that occupational health safety guidelines be created for the forensic medicine discipline and crime scene attendants in South Africa.