Detection of HIV in human vitreous

Abstract

Assay of human vitreous specimens obtained postmortem for HIV antibodies, or HIV p24 antigen, is reported to be a reliable technique to demonstrate HIV infection in possible cornea donors from whom serum could not be obtained. We tested three vitreous samples obtained during vitrectomy from two HIV-positive patients. One patient exhibited the clinical AIDS syndrome. HIV antigen and antibody tests were negative in all specimens. HIV proviral DNA was detected by PCR only in the vitreous of the patient with AIDS. Therefore, testing only vitreous samples is insufficient to exclude HIV infection in potential cornea donors.

Human immunodeficiency virus in cadavers: A review

“…Some post‐mortem studies used different tissues to ascertain if a certain tissue might be more effective compared to blood or serum. These tissues included pleural fluid (Douceron et al , ), pericardial fluid (Douceron et al ), skin (Gala et al ), lymph nodes (Nyberg et al ; Ball et al ; Padley et al ), bile (Karhunen et al ), lung (Ball et al ), brain (Nyberg et al ; Ball et al ), spleen (Nyberg et al ; Ball et al ), cerebrospinal fluid (Nyberg et al ; Ball et al ), bone (Nyberg et al ; Salzman et al ), bone marrow (Nyberg et al ) and vitreous fluid (Pepose et al ; Klatt et al ; Mietz et al ; Karhunen et al ; Schor et al ). In the majority of cases, HIV could be detected in most samples, with similar reliability to blood or serum.…”

“…As vitreous humor can easily be retrieved from the body, several researchers tested vitreous humor for HIV. Unfortunately, most studies concluded that testing vitreous humor was unreliable compared to other bodily fluids because a high false negative rate was reported (Pepose et al ; Klatt et al ; Mietz et al ; Schor et al ). In contrast, Karhunen et al () consistently detected HIV in vitreous fluid using several different types of tests.…”

ACP Best Practice No 164: Necropsy techniques in ophthalmic pathology

“…Even removal of the vitreous carries a small risk of needle stick injuries, and the vitreous is known to harbour pathogens such as human immunodeficiency virus. 22 In addition to the usual infectious agents potentially encountered at necropsy, 3 the eye is one of the tissues with the highest titres of infectivity for the human and animal transmissible spongiform encephalopathies, and infectivity is present in unfixed or routinely fixed tissues. 23 In view of the small risk of infection of necropsy workers, the advisory committee on dangerous pathogens and Department of Health have issued guidelines for the UK, which are considered to represent "good practice".…”