Long-lasting postmortem viability of human immunodeficiency virus: a potential risk in forensic medicine practice

To determine the time from death when an autopsy could be carried out without any risk of contamination by human immunodeficiency virus (HIV), we cultured HIV from serial samples of blood and liquid effusion, collected as long as possible alter death from refrigerated dead bodies of HIV-infected patients. Samples were cocultivated with stimulated normal human lymphocytes and viral replication was assessed by p24 HIV1 antigen ELISA determination and by reverse transcriptase HIV1 and HIV2 activity microassay. Viable HIV was isolated from blood obtained 16.5 days postmortem, from pleural liquid effusion obtained 13.8 days postmortem, and from pericardial liquid effusion obtained 15.5 days postmortem. Viral replication was in evidence in at least one sample from all nine patients of the study. The present study did not allow us to determine a time from death when an autopsy could be carried out without any risk of contamination by HIV. We conclude that postponement of autopsies does not eliminate occupational risk of contamination by HIV.