Abstract
Although detection of disease-induced hepatitis A virus (HAV)-specific antibodies in saliva has been successfully utilized in a few epidemiological studies, available assays fail to detect lower salivary anti-HAV levels associated with vaccine-induced immunity. We present a new capture enzyme immunoassay which employs a three-layer antibody recognition system. Evaluation of paired saliva-serum specimens from 1,025 international travellers, 134 other volunteers, and 91 hepatitis A vaccine recipients demonstrated 99.6% (95% confidence interval, 98.4 to 99.9) specificity and 98.7% (95% confidence interval, 97.7 to 99.4) sensitivity of this salivary assay in differentiating between immune and susceptible individuals, compared with serum-based methods. We conclude that this assay is sufficiently sensitive for reliable detection of both vaccine- and infection-induced HAV-specific immunoglobulin G in saliva, even when corresponding anti-HAV levels in serum are very low (< 1 IU/ml).
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Selected References
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- Aiyar J., Bhan M. K., Bhandari N., Kumar R., Raj P., Sazawal S. Rotavirus-specific antibody response in saliva of infants with rotavirus diarrhea. J Infect Dis. 1990 Dec;162(6):1383–1384. doi: 10.1093/infdis/162.6.1383. [DOI] [PubMed] [Google Scholar]
- André F. E., Hepburn A., D'Hondt E. Inactivated candidate vaccines for hepatitis A. Prog Med Virol. 1990;37:72–95. [PubMed] [Google Scholar]
- Challacombe S. J., Russell M. W., Hawkes J. E., Bergmeier L. A., Lehner T. Passage of immunoglobulins from plasma to the oral cavity in rhesus monkeys. Immunology. 1978 Dec;35(6):923–931. [PMC free article] [PubMed] [Google Scholar]
- Cordeiro M. L., Turpin C. S., McAdams S. A. A comparative study of saliva and OraSure oral fluid. Ann N Y Acad Sci. 1993 Sep 20;694:330–331. doi: 10.1111/j.1749-6632.1993.tb18380.x. [DOI] [PubMed] [Google Scholar]
- Duermeyer W., van der Veen J. Specific detection of IgM-antibodies by ELISA, applied in hepatitis-A. Lancet. 1978 Sep 23;2(8091):684–685. doi: 10.1016/s0140-6736(78)92802-7. [DOI] [PubMed] [Google Scholar]
- Hurni W. M., Laufer D., Miller W. J., Ryan J., Watson B. Anti-hepatitis A in the general population and in hepatitis A vaccinees using saliva and serum as diagnostic media. Ann N Y Acad Sci. 1993 Sep 20;694:289–292. doi: 10.1111/j.1749-6632.1993.tb18367.x. [DOI] [PubMed] [Google Scholar]
- Laufer D. S., Hurni W., Watson B., Miller W., Ryan J., Nalin D., Brown L. Saliva and serum as diagnostic media for antibody to hepatitis A virus in adults and in individuals who have received an inactivated hepatitis A vaccine. Clin Infect Dis. 1995 Apr;20(4):868–871. doi: 10.1093/clinids/20.4.868. [DOI] [PubMed] [Google Scholar]
- Macy E., Kemeny M., Saxon A. Enhanced ELISA: how to measure less than 10 picograms of a specific protein (immunoglobulin) in less than 8 hours. FASEB J. 1988 Nov;2(14):3003–3009. doi: 10.1096/fasebj.2.14.3263291. [DOI] [PubMed] [Google Scholar]
- Parry J. V. Detection of viral antibodies in saliva specimens as an alternative to serum. J Clin Chem Clin Biochem. 1989 Apr;27(4):245–246. [PubMed] [Google Scholar]
- Parry J. V., Farrington C. P., Perry K. R., Waight P. A., Mortimer P. P., Miller E. Rational programme for screening travellers for antibodies to hepatitis A virus. Lancet. 1988 Jun 25;1(8600):1447–1449. doi: 10.1016/s0140-6736(88)92250-7. [DOI] [PubMed] [Google Scholar]
- Parry J. V., Perry K. R., Mortimer P. P. Sensitive assays for viral antibodies in saliva: an alternative to tests on serum. Lancet. 1987 Jul 11;2(8550):72–75. doi: 10.1016/s0140-6736(87)92737-1. [DOI] [PubMed] [Google Scholar]
- Parry J. V., Perry K. R., Panday S., Mortimer P. P. Diagnosis of hepatitis A and B by testing saliva. J Med Virol. 1989 Aug;28(4):255–260. doi: 10.1002/jmv.1890280410. [DOI] [PubMed] [Google Scholar]
- Parry J. V. Simple and reliable salivary tests for HIV and hepatitis A and B virus diagnosis and surveillance. Ann N Y Acad Sci. 1993 Sep 20;694:216–233. doi: 10.1111/j.1749-6632.1993.tb18355.x. [DOI] [PubMed] [Google Scholar]
- Perry K. R., Brown D. W., Parry J. V., Panday S., Pipkin C., Richards A. Detection of measles, mumps, and rubella antibodies in saliva using antibody capture radioimmunoassay. J Med Virol. 1993 Jul;40(3):235–240. doi: 10.1002/jmv.1890400312. [DOI] [PubMed] [Google Scholar]
- Thieme T., Piacentini S., Davidson S., Steingart K. Determination of measles, mumps, and rubella immunization status using oral fluid samples. JAMA. 1994 Jul 20;272(3):219–221. [PubMed] [Google Scholar]
- Thieme T., Yoshihara P., Piacentini S., Beller M. Clinical evaluation of oral fluid samples for diagnosis of viral hepatitis. J Clin Microbiol. 1992 May;30(5):1076–1079. doi: 10.1128/jcm.30.5.1076-1079.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zaaijer H. L., Leentvaar-Kuijpers A., Rotman H., Lelie P. N. Hepatitis A antibody titres after infection and immunization: implications for passive and active immunization. J Med Virol. 1993 May;40(1):22–27. doi: 10.1002/jmv.1890400106. [DOI] [PubMed] [Google Scholar]