Postmortem Testing for HIV, HBV, and HCV: Insights from Autopsy Findings.

Introduction: A body brought for autopsy is full of information, which is visible only to those who are willing to see it carefully The cause of death can be natural or unnatural or it can be unnatural complicated by a natural cause i.e. disease complicating the trauma. Sometimes, the deceased could be suffering from some undiagnosed disease which can have infective or non-infective etiology. In case of infective etiology, the infection can spread from the bodies brought for autopsy to the medical examiners and other autopsy room workers by droplets, by direct contact or by injuries with needles and sharp instruments. This study is conducted to screen the blood samples obtained from the bodies brought for autopsy for Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV).

Aim: To assess the proportion of bodies at the risk of transmission of HIV, HBV and HCV infection to the medical examiners and autopsy room workers.

Objectives: To find out the undiagnosed cases of HIV, HBV and HCV virus infection among the bodies brought for autopsy and to determine the risk of infectivity of these viruses to the medical examiners and autopsy room workers.

Methodology: This was a cross-sectional prospective study conducted in the Department of Forensic Medicine & Toxicology in collaboration with the Department of Microbiology, Shri Lal Bahadur Shastri Government Medical College & Hospital, Mandi at Nerchowk (H.P.) between 1st June 2022 to 31st December 2023 on all the bodies brought for autopsy to the Department of Forensic Medicine & Toxicology, SLBSGMC&H Mandi at Nerchowk.

Results: Our study included a total of 259 autopsy cases conducted in the Department of Forensic Medicine at SLBSGMC Mandi at Nerchowk. Among the total cases, 206 (79.54%) of the cases were males. 206 (79.54%) of the subjects were in the age group of 21-60 years. Among the sent samples, 228 (88.03%) samples were subjected to testing for HIV, HBV and HCV. Two (0.87%) samples were found positive for HIV, five (2.19%) were found positive for HBV and one (0.43%) was found positive for HCV. Among the 7 cases positive for either of the antigens, only one (14.29%) had co-infection of HIV and HBV, 5 (71.43%) were males and 2 (28.57%) were females. Only one (14.29%) among the 7 cases was uneducated and others had the education level of matriculate or above, 6 (85.71%) were from the population of young adults (ranging from 16-32 years), 5 (71.43%) subjects had the history of intravenous substance abuse. All of the subjects were undiagnosed for any of the viral antigen.

Conclusion: Our study showed that the medical examiners, autopsy room workers & other departments who are dealing with the dead bodies are at a risk of HIV, Hepatitis B and Hepatitis C virus infection as the prevalence of these viral infections in our study was found higher than the national and regional prevalence. These viruses survive in the dead bodies for a certain duration and can be transmitted to the persons dealing with such bodies. Most of these viruses were detected in the bodies belonging to young age group in which there was history of intravenous substance abuse. There were undiagnosed cases of these viral infections, regarding which the medical examiners and autopsy room workers were unaware of. This necessitates the screening of dead bodies for these viral infections before conducting the autopsy.