COMPARISON OF SALIVA AND SERUM FOR HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 ANTIBODY TESTING IN UGANDA USING A RAPID RECOMBINANT ASSAY

The accuracy and acceptability of saliva human immunodeficiency virus type 1 (HIV-1) antibody testing were compared with serum testing in a study of paired specimens from HIV-1-seropositive and HIV-1-seronegati ve Ugandan adults attending a clinic for sexually transmitted diseases . Saliva collection was performed with the Omni-sal device (Saliva Dia gnostic Systems, Vancouver, Wash.), and antibody testing was performed by a rapid filter paper essay (Test-Pack; Abbott Laboratories, Abbott Park, Ill.). Relative to serum testing, the sensitivity of saliva tes ting was 95% (195 of 205) and the specificity was 99% (295 of 297). Th e sensitivity of saliva testing was higher for patients with elevated levels of beta-2 microglobulin in sera and greater numbers of HIV-1-re lated symptoms. Pre- and poststudy interviews indicated that saliva te sting did not foster inordinate fears of saliva exposure, The developm ent of saliva tests that are inexpensive and do not require electricit y is needed.