Screening for human immunodeficiency virus antibody in urine

Area of Science:

• Immunology
• Infectious Diseases
• Diagnostic Medicine

Background:

• Accurate human immunodeficiency virus (HIV) diagnosis is crucial for patient management and public health.
• Alternative sample types for HIV testing, such as urine, may offer advantages over traditional blood or serum testing.
• The diagnostic performance of novel urine-based HIV antibody tests requires rigorous evaluation.

Purpose of the Study:

• To evaluate the diagnostic accuracy of an investigational urine test for detecting HIV envelope antibodies.
• To compare the performance of urine-based HIV testing with conventional blood-based methods.

Main Methods:

• Matched blood and urine specimens were collected from 592 recovering alcoholics at six San Francisco treatment centers.
• Two independent laboratories performed HIV testing using enzyme-linked immunoassay (EIA) and western blot.
• Urine EIA results were confirmed by urine western blot; positive blood EIA results were confirmed by immunofluorescent antibody or western blot.

Main Results:

• The investigational urine HIV antibody test, confirmed by western blot, correctly diagnosed all samples.
• No false positive or false negative results were observed with the urine-based HIV test.
• One sample showed an indeterminate pattern on blood western blot but was correctly negative by urine screening.

Conclusions:

• The investigational urine HIV antibody test demonstrated high diagnostic accuracy with no false results in this cohort.
• Urine HIV testing presents potential advantages over serum or blood testing.
• Careful consideration of specific clinical scenarios is warranted when deciding on the use of alternative specimens for HIV testing.