Postmortem Detection of Hepatitis B, C, and Human Immunodeficiency Virus Genomes in Blood Samples From Drug-Related Deaths in Denmark

• NCJ Number: 228516
• Journal: Journal of Forensic Sciences Volume: 54 Issue: 5 Dated: September 2009 Pages: 1085-1088
• Author(s): Mette Brandt Eriksen, M.S.; Marianne Antonius Jakobsen, Ph.D.; Birgitte Kringsholm, M.D.; Jytte Banner, Ph.D.; Jorgen L. Thomsen, M.D.; Jorgen Georgsen, M.D.; Court Pedersen M.D.; Peer Brehm Christensen, Ph.D.
• Date Published: September 2009
• Length: 4 pages
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

In monitoring the prevalence of HBV (hepatitis B virus), HCV (hepatitis C virus), and HIV (human immunodeficiency virus) infections among Danish drug users, the Danish Board of Health conducted a national prospective cohort study that tested postmortem blood samples among 233 decedents in drug-related deaths in 2004, which included the aim of determining whether testing seropositive samples for the corresponding viral genome by polymerase chain reaction (PCR) could be used to monitor the prevalence of ongoing viral infections.

Abstract

The study succeeded in demonstrating the feasibility of detecting viral genomes in blood samples collected during routine autopsy from persons who died form drug-related causes. The samples were collected a median of 4 days after death and forwarded for examination without precautions to preserve nucleic acids. PCR was performed on all samples. A human gene was detected in all samples tested, indicating the presence of intact DNA. HBV DNA was detected and confirmed by sequencing in 20 percent of samples analyzed, which agreed with data from a previous study among living Danish drug users. The study concluded that ongoing HBV and HCV infections could be reliably detected postmortem by viral nucleic acid testing. HIV RNA detection was feasible but was probably less sensitive than anti-HIV serological analysis. In addition, the cost of the PCR testing was 10 times greater than that of serological testing. The advantage of PCR is that it detects ongoing viral infections at death and enables sequence analysis that can be used to investigate routes of transmission. The authors view nucleic acid testing as a useful supplement to postmortem serological testing; however, it cannot replace antibody testing in order to determine the prevalence of past infections or the proportion protected by HBV vaccine. 3 tables and 16 references