Detection of Hhuman Immunodeficiency Virus in Corpsic Blood: New Opportunities for Optimizing Epidemiological Surveillance and Safety Systems

Aim. To determine HIV antibodies and viral load levels in cadaveric blood samples from individuals with undiagnosed HIV infection during their lifetime, and to propose measures to optimize the system of epidemiological surveillance and safety. Materials and methods. A targeted screening of 710 cadaveric blood samples was conducted, received from the forensic medical examination bureau. Blood sampling was performed from the heart cavities or large vessels in accordance with the regulatory documents of the Russian Ministry of Health. The exact time of sample collection relative to the moment of death was not recorded, but it typically occurred within several hours after death was confirmed. The lifetime HIV status of the deceased was unknown. A total of 710 samples were analyzed; HIV was confirmed in 1.5 % of cases (n = 11). Primary detection of HIV-1/2 antibodies and p24 antigen was performed using the “MilaLab-ELISA-HIV-Ag+At” enzyme immunoassay test system. Seropositivity confirmation and antibody profile determination were performed using immune blot testing with the “MilaBlot-HIV” kit. To assess epidemiological risk in seropositive individuals, quantitative determination of HIV-1 RNA was performed using PCR (“AmpliSense HIV-MONITOR-FRT” kit). Viral load could not be determined in two samples due to hemolysis. Results. Positive immune blot for HIV was detected in 1.5% of samples. Antibodies to gp160 and gp41 proteins were detected in 100 % of cases, to gp120, p31, and gag24 − in 91 %, to gp36 − in 27 % (3/11), to p51/66 and gag17 − in 64 % (7/11). Viral load results ranged from 48 to 390,000 copies/ ml. In the vast majority of cases (78 %), the viral load exceeded 1,000 copies/ml, indicating high risks of HIV transmission. Conclusion. The obtained data indicate the need for validation of existing test systems for postmortem HIV diagnosis; development of an algorithm for epidemiological detection of HIV infection cases in cadaveric blood; examination of first-line contact persons; strengthening epidemiological safety measures for thanatologists and medical personnel when working with cadaveric material.