Determination of Human Immunodeficiency Virus Antibody Status in Forensic Autopsy Cases Using a Rapid and Simple FDA-Licensed Assay

Abstract

Evaluation of an FDA-licensed rapid assay to detect antibodies to human immunodeficiency virus (HIV) was accomplished by testing 414 serum samples collected sequentially from autopsy cases at the Office of the Chief Medical Examiner, State of Maryland. The time of postmortem collection ranged from 8 to 30 hours. All samples were tested for the presence of antibodies to HIV using a rapid peptide microfiltration assay (SUDS HIV-1 test, Murex Corporation, Norcross, GA), and an enzyme-linked immunosorbent assay (ELISA). Samples yielding repeatedly reactive results were confirmed by Western blot. Of the 414 specimens, 23 (5.6%) produced reactive results by both SUDS and ELISA, and were confirmed by Western blot. One additional sample was repeatedly reactive by ELISA but negative by the SUDS test. This sample produced an indeterminate profile by Western blot (reactivity to only p24) and was negative by several additional retroviral assays. Of the 23 HIV infected cases, 16 had risk factors for HIV infection; 19 were blacks and 18 were male. The SUDS, 10 minute test, exhibited a 100% sensitivity and 100% specificity in comparison to FDA-licensed ELISA and Western blot assays for detecting HIV antibody in autopsy serum specimens. We conclude that this rapid, simply performed assay is accurate and applicable for use in several testing situations, including autopsy rooms.