Postmortem diagnostics of HIV infection, hepatitis B and C, syphilis in forensic medical examination institution: results of a cross-sectional study in Tyumen region

Postmortem diagnostics of HIV infection, hepatitis B, C and syphilis in forensic medical examination institutions can provide access to the study of prevalence in key population groups, improve the quality of statistical data, increase the validity of forensic medical diagnoses and map biological risks. This potential, however, has not been realized today.

The purpose of research was to assess the prevalence of HIV infection, hepatitis B and C, syphilis based on the results of a study of blood serum taken from corpses admitted to a forensic medical examination institution; assessment and analysis of the comorbidity level of socially significant infections in the study population.

The research materials included blood taken from corpses admitted to the State Budgetary Healthcare Institution of the Tyumen Region “Regional Bureau of Forensic Medical Examination” in accordance with the current sanitary rules and regulations 3.3681-31.

Research methods. Markers of HIV infection, viral hepatitis B, C and syphilis were determined using commercial test systems approved for use in Russia. A statistical analysis was performed based on the results.

The results of research. Postmortem examination of blood serum from deceased individuals revealed serological markers of one or more of the above infections in 35.8% of cases. According to the study results, the chance of detecting antibodies to the hepatitis C virus in corpses with HIV infection was 12.96 times higher than in corpses without HIV infection, and the chance of detecting serological markers of two viral hepatitis infections simultaneously was 7.26 times higher. The presence of any marker of a socially significant infection significantly increases the likelihood of detecting another marker. The discussion of the obtained results includes a comparison of the obtained results with regional data and the results of similar foreign studies, and a significant limitation of the study, namely, the use of test systems that are not validated for studying cadaveric blood, is discussed in detail.

Conclusion. Diagnostics of HIV infection, hepatitis B and C, syphilis during forensic autopsies allows access to testing in key population groups. Taking into account the data obtained in the course of our study, in order to improve the epidemiological surveillance system and improve preventive measures, the authors propose the introduction of expanded laboratory postmortem diagnostics of HIV infection, hepatitis B, C and syphilis during autopsies, provided that adequate algorithms for testing cadaveric blood are developed, taking into account the diagnostic sensitivity of test systems used in postmortem diagnostics of infections.

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