Use of saliva as an alternative to serum for HIV screening in Africa

Saliva has been recommended as a safe and effective alternative to serum for enzyme-linked immunosorbent assay (ELISA) for HIV antibodies in surveillance programmes in developing countries. We evaluated the use of saliva specimens for detection of HIV antibodies using three different commercially available ELISAs. Saliva specimens from 107 patients selected at random from HIV high-risk (38), medium-risk (27) and low-risk (42) areas of the hospital were screened with the Wellcozyme HIV1 + 2 GACELISA VK61 (recommended for use with saliva), Wellcozyme HIV1 + 2 VK54/55 and Wellcozyme HIV-1 recombinant VK56/57. Of the 107 patients, 50 were positive and 57 negative for antibodies to HIV on confirmatory Western blot testing. For detection of antibodies to HIV in saliva, the Wellcozyme HIV1 + 2 GACELISA VK61 had a sensitivity and a specificity of 98%, the Wellcozyme HIV-1 recombinant VK56/57 a sensitivity and specificity of 96%, and the Wellcozyme HIV1 + 2 VK54/55 a sensitivity of 94% and a specificity of 95%. For detection of antibodies to HIV in serum, the Wellcozyme HIV-1 recombinant VK56/57 had a sensitivity and a specificity of 100%, the Wellcozyme HIV1 + 2 GACELISA VK61 a sensitivity and a specificity of 98%, and the Wellcozyme HIV1 + 2 VK54/55 a sensitivity and a specificity of 96%. This study illustrates that saliva can be used as an alternative to serum for screening for anti-HIV antibodies in African patients.