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. 1994;72(1):135–143.

Serological diagnosis of HIV infection using oral fluid samples.

H Tamashiro 1, N T Constantine 1
PMCID: PMC2486497  PMID: 8131250

Abstract

The serological identification of antibodies to human immunodeficiency virus (HIV) in blood is the most widely used method to diagnose HIV infection. Recently, however, the use of oral fluid samples for the detection of antibodies to HIV has been suggested as an alternative. This review describes some basic information about oral fluids, the application of these samples for HIV testing, and summarizes results from many of the studies performed using HIV tests with oral fluids. The fluids obtained from the oral cavity include saliva and crevicular fluid, and can be collected directly (by dribbling) or by using commercially available devices. The immunoglobulin content of oral fluids is similar to that of blood, but their levels are less. However, the use of an HIV IgG antibody capture assay (GAC ELISA) designed specifically for testing oral fluids, and certain routine HIV blood tests that have been optimized for use with oral fluids, has produced encouraging results. A number of studies, including several in developing countries, report that the sensitivities and specificities of these optimized tests lie in the range 95-100% and 98-100%, respectively. Also, the performance of the GAC ELISA was consistent and in general, excellent. The article identifies several issues that need to be addressed before a recommendation on the routine use of oral fluid samples for HIV antibody detection can be made.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Archibald D. W., Barr C. E., Torosian J. P., McLane M. F., Essex M. Secretory IgA antibodies to human immunodeficiency virus in the parotid saliva of patients with AIDS and AIDS-related complex. J Infect Dis. 1987 Apr;155(4):793–796. doi: 10.1093/infdis/155.4.793. [DOI] [PubMed] [Google Scholar]
  2. Archibald D. W., Hebert C. A. Salivary detection of HIV-1 antibodies using recombinant HIV-1 peptides. Viral Immunol. 1991 Spring;4(1):17–22. doi: 10.1089/vim.1991.4.17. [DOI] [PubMed] [Google Scholar]
  3. Archibald D. W., Hebert C. A., Sun D., Tacket C. O. Salivary antibodies to human immunodeficiency virus type 1 in a phase I AIDS vaccine trial. J Acquir Immune Defic Syndr. 1990;3(10):954–958. [PubMed] [Google Scholar]
  4. Archibald D. W., Johnson J. P., Nair P., Alger L. S., Hebert C. A., Davis E., Hines S. E. Detection of salivary immunoglobulin A antibodies to HIV-1 in infants and children. AIDS. 1990 May;4(5):417–420. doi: 10.1097/00002030-199005000-00006. [DOI] [PubMed] [Google Scholar]
  5. Archibald D. W., Zon L., Groopman J. E., McLane M. F., Essex M. Antibodies to human T-lymphotropic virus type III (HTLV-III) in saliva of acquired immunodeficiency syndrome (AIDS) patients and in persons at risk for AIDS. Blood. 1986 Mar;67(3):831–834. [PubMed] [Google Scholar]
  6. Archibald D., Essex M., McLane M. F., Sauk J., Tachibana N., Mueller N. Antibodies to HTLV-1 in saliva of seropositive individuals from Japan. Viral Immunol. 1987;1(4):241–246. doi: 10.1089/vim.1987.1.241. [DOI] [PubMed] [Google Scholar]
  7. Bagg J., Perry K. R., Parry J. V., Mortimer P. P., Peters T. J. The influence of dental status on the detection of IgG class anti-viral antibodies in human saliva. Arch Oral Biol. 1991;36(3):221–226. doi: 10.1016/0003-9969(91)90089-d. [DOI] [PubMed] [Google Scholar]
  8. Behets F. M., Edidi B., Quinn T. C., Atikala L., Bishagara K., Nzila N., Laga M., Piot P., Ryder R. W., Brown C. C. Detection of salivary HIV-1-specific IgG antibodies in high-risk populations in Zaire. J Acquir Immune Defic Syndr. 1991;4(2):183–187. [PubMed] [Google Scholar]
  9. Burke D. S. Laboratory diagnosis of human immunodeficiency virus infection. Clin Lab Med. 1989 Sep;9(3):369–392. [PubMed] [Google Scholar]
  10. Cheingsong-Popov R., Callow D., Weber J., Holm-Hansen C., Constantine N. T. Antibody to specific HIV-1 proteins in oral mucosal transudates. Lancet. 1993 Jun 26;341(8861):1659–1660. doi: 10.1016/0140-6736(93)90789-j. [DOI] [PubMed] [Google Scholar]
  11. Coates R., Millson M., Myers T., Rankin J., McLaughlin B., Major C., Rigby J., Mindell W. The benefits of HIV antibody testing of saliva in field research. Can J Public Health. 1991 Nov-Dec;82(6):397–398. [PubMed] [Google Scholar]
  12. Covell R., Follett E., Coote I., Bloor M., Finlay A., Frischer M., Goldberg D., Green S., Haw S., McKeganey N. HIV testing among injecting drug users in Glasgow. J Infect. 1993 Jan;26(1):27–31. doi: 10.1016/0163-4453(93)96712-y. [DOI] [PubMed] [Google Scholar]
  13. Crofts N., Nicholson S., Coghlan P., Gust I. D. Testing of saliva for antibodies to HIV-1. AIDS. 1991 May;5(5):561–563. [PubMed] [Google Scholar]
  14. Farzadegan H., Quinn T., Polk B. F. Detecting antibodies to human immunodeficiency virus in dried blood on filter papers. J Infect Dis. 1987 May;155(5):1073–1074. doi: 10.1093/infdis/155.5.1073. [DOI] [PubMed] [Google Scholar]
  15. Frerichs R. R., Htoon M. T., Eskes N., Lwin S. Comparison of saliva and serum for HIV surveillance in developing countries. Lancet. 1992 Dec 19;340(8834-8835):1496–1499. doi: 10.1016/0140-6736(92)92755-5. [DOI] [PubMed] [Google Scholar]
  16. Gershy-Damet G. M., Koffi K., Abouya L., Sasson-Morokro M., Brattegaard K., Parry J. V., De Cock K. M., Mortimer P. P. Salivary and urinary diagnosis of human immunodeficiency viruses 1 and 2 infection in Côte d'Ivoire, using two assays. Trans R Soc Trop Med Hyg. 1992 Nov-Dec;86(6):670–671. doi: 10.1016/0035-9203(92)90184-e. [DOI] [PubMed] [Google Scholar]
  17. Heathcote J., Cameron C. H., Dane D. S. Hepatitis-B antigen in saliva and semen. Lancet. 1974 Jan 19;1(7847):71–73. doi: 10.1016/s0140-6736(74)92289-2. [DOI] [PubMed] [Google Scholar]
  18. Holm-Hansen C., Constantine N. T., Haukenes G. Detection of antibodies to HIV in homologous sets of plasma, urine and oral mucosal transudate samples using rapid assays in Tanzania. Clin Diagn Virol. 1993 Oct;1(4):207–214. doi: 10.1016/0928-0197(93)90002-m. [DOI] [PubMed] [Google Scholar]
  19. Holmström P., Syrjänen S., Laine P., Suni J. HIV antigens detected in gingival fluid. AIDS. 1992 Jul;6(7):738–739. doi: 10.1097/00002030-199207000-00020. [DOI] [PubMed] [Google Scholar]
  20. Holmström P., Syrjänen S., Laine P., Valle S. L., Suni J. HIV antibodies in whole saliva detected by ELISA and western blot assays. J Med Virol. 1990 Apr;30(4):245–248. doi: 10.1002/jmv.1890300403. [DOI] [PubMed] [Google Scholar]
  21. Johnson A. M., Parry J. V., Best S. J., Smith A. M., de Silva M., Mortimer P. P. HIV surveillance by testing saliva. AIDS. 1988 Oct;2(5):369–371. doi: 10.1097/00002030-198810000-00006. [DOI] [PubMed] [Google Scholar]
  22. Klokke A. H., Ocheng D., Kalluvya S. E., Nicoll A. G., Laukamm-Josten U., Parry J. V., Mortimer P. P., Connell J. A. Field evaluation of immunoglobulin G antibody capture tests for HIV-1 and HIV-2 antibodies in African serum, saliva and urine. AIDS. 1991 Nov;5(11):1391–1392. doi: 10.1097/00002030-199111000-00022. [DOI] [PubMed] [Google Scholar]
  23. Mandel I. D. The diagnostic uses of saliva. J Oral Pathol Med. 1990 Mar;19(3):119–125. doi: 10.1111/j.1600-0714.1990.tb00809.x. [DOI] [PubMed] [Google Scholar]
  24. O'Shea S., Cordery M., Barrett W. Y., Richman D. D., Bradbeer C., Banatvala J. E. HIV excretion patterns and specific antibody responses in body fluids. J Med Virol. 1990 Aug;31(4):291–296. doi: 10.1002/jmv.1890310409. [DOI] [PubMed] [Google Scholar]
  26. 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]
  27. 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]
  28. Shoeman R. L., Pottathil R., Metroka C. Antibodies to HIV in saliva. N Engl J Med. 1989 Apr 27;320(17):1145–1146. doi: 10.1056/NEJM198904273201712. [DOI] [PubMed] [Google Scholar]
  29. Soto-Ramírez L. E., Hernández-Gómez L., Sifuentes-Osornio J., Barriga-Angulo G., Duarte de Lima D., López-Portillo M., Ruiz-Palacios G. M. Detection of specific antibodies in gingival crevicular transudate by enzyme-linked immunosorbent assay for diagnosis of human immunodeficiency virus type 1 infection. J Clin Microbiol. 1992 Nov;30(11):2780–2783. doi: 10.1128/jcm.30.11.2780-2783.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Sun D., Archibald D. W., Furth P. A. Variation of secretory antibodies in parotid saliva to human immunodeficiency virus type 1 with HIV-1 disease stage. AIDS Res Hum Retroviruses. 1990 Jul;6(7):933–941. doi: 10.1089/aid.1990.6.933. [DOI] [PubMed] [Google Scholar]
  31. Tamashiro H., Maskill W., Emmanuel J., Fauquex A., Sato P., Heymann D. Reducing the cost of HIV antibody testing. Lancet. 1993 Jul 10;342(8863):87–90. doi: 10.1016/0140-6736(93)91289-x. [DOI] [PubMed] [Google Scholar]
  32. 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]
  33. Thongcharoen P., Wasi C., Louisirirotchanakul S., Parry J., Connell J., Mortimer P. Immunoglobulin G antibody capture enzyme-linked immunosorbent assay: a versatile assay for detection of anti-human immunodeficiency virus type 1 and 2 antibodies in body fluids. J Clin Microbiol. 1992 Dec;30(12):3288–3289. doi: 10.1128/jcm.30.12.3288-3289.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. U.S. National Institutes of Health. Recombinant DNA Advisory Committee Minutes of meeting, 4 Feb 1991. Hum Gene Ther. 1991 Winter;2(4):397–413. doi: 10.1089/hum.1991.2.4-397. [DOI] [PubMed] [Google Scholar]
  35. Vasudevachari M. B., Uffelman K. W., Kovacs J., Yeh C. K., Lane H. C., Salzman N. P. Envelope-specific antibodies in the saliva of individuals vaccinated with recombinant HIV-1 gp160. J Acquir Immune Defic Syndr. 1992;5(8):817–821. [PubMed] [Google Scholar]
  36. van den Akker R., van den Hoek J. A., van den Akker W. M., Kooy H., Vijge E., Roosendaal G., Coutinho R. A., van Loon A. M. Detection of HIV antibodies in saliva as a tool for epidemiological studies. AIDS. 1992 Sep;6(9):953–957. doi: 10.1097/00002030-199209000-00007. [DOI] [PubMed] [Google Scholar]

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