SCREENING FOR HUMAN-IMMUNODEFICIENCY-VIRUS ANTIBODY IN URINE

Objective.-To determine the diagnostic accuracy of an investigational test for human immunodeficiency virus (HIV) envelope antibodies in uri ne. Design.-Matched blood and urine specimens were tested for HIV by t wo independent laboratories, both of which were blinded to all results at the other site. Duplicate positive enzyme-linked immunoassay (EIA) results were confirmed by immunofluorescent antibody or western blot. Setting.-Six alcohol treatment centers in the San Francisco metropoli tan area.Patients.-Five hundred ninety-two recovering alcoholics. Main Outcome Measures.-Diagnosis of HIV infection by blood and urine EIA a nd western blot. Results.-The experimental urine EIA, when confirmed b y urine western blot, led to a correct diagnosis in all samples. One s ample was negative by urine EIA screening, positive by blood EIA, and exhibited an indeterminate blood western blot pattern (p24 band only). Conclusions.-We encountered no false positive or false negative resul ts using an investigational HIV antibody test for urine samples. There are several important advantages to HIV testing of urine versus serum or blood; however, there are also cogent reasons for limiting the use of alternative specimens for HIV testing.