Immunological and molecular detection of human immunodeficiency virus in saliva, and comparison with blood testing

Abstract

In order to test the detection feasibility of human immunodeficiency virus (HIV) in saliva, a three-method blind screening analysis was conducted. Sixty-eight individuals were studied, comprising 34 HIV carriers and 34 noncarriers (controls) of matched gender and age. An oral examination preceded saliva and blood sampling of studied individuals. All samples were tested blind for HIV by using two immunological methods [Oraquick-compatible enzyme-linked immunosorbent assay (ELISA) and a fluorescent immunoenzymatic method (ELFA)], confirmed by western blotting, and a simple molecular method (polymerase chain reaction amplification of a relatively constant viral DNA region), confirmed by DNA hydridization. Compared with the controls, about twice as many HIV carriers had oral health problems, including periodontal disease. ELFA resulted in 33/34 positives and 34/34 negatives in saliva, while it detected 34/34 positives and 34/34 negatives in blood. ELISA performed even better, with correct assignment of all positives and negatives in both saliva and blood. The PCR method, at three annealing temperatures, surprisingly detected all positive samples, while it gave no false-positive result. In conclusion, the detection of anti-HIV in saliva may achieve accuracy of 97.1-100%, comparable with that in blood. Furthermore, this study suggests that a highly accurate molecular method of HIV detection may be feasible, although the studied carriers had rather homogeneous characteristics.

Saliva as a Diagnostic Fluid

“…For instance, the standard approach for HIV clinical laboratory diagnosis has been testing serum or plasma samples in a sensitive ELISA followed by a Western blot if the ELISA is positive. However, oral fluids have also been successfully used in lab diagnostics to detect HIV antigen and antibodies in different nucleic- and immunoassay formats such as qRT-PCR, ELISA, rapid test, POC and microfluidic diagnostic devices [18, 109, 110, 111, 112, 113, 114, 115, 116]. Additionally, HIV neutralizing innate immune factors such as defensins have also been successfully detected in saliva using sophisticated experimental methodologies such as liquid chromatography-tandem mass spectrometry that involves limited sample manipulation and that can be easily automated [117].…”

Evaluation of saliva self-collection devices for SARS-CoV-2 diagnostics

“…While saliva has been used as a diagnostic testing substrate for pathogenic antibodies [ 8 – 10 ], its utility in viral pathogen detection has been limited to viruses like human immunodeficiency virus [ 11 ], measles, mumps, and rubella [ 12 ], human papillomavirus [ 13 ], Epstein–Barr virus [ 14 ] and certain viral co-infections [ 15 – 17 ], all strictly in research settings. Before 2020, the only PCR-based diagnostic test using saliva (saliva swabs) approved or authorized by the U.S. Food and Drug Administration (FDA) was for the detection of human cytomegalovirus in babies [ 18 ].…”

Effects of Highly Active Antiretroviral Therapy on HIV-1-Associated Oral Complications

“…submandibular, 65%, Parotid, 23%, sublingual, 4% and 8% by minor glands) [16]. A number of studies have demonstrated that HIV-1 can be detected in the saliva of infected-individuals [89,149,177]. Although the levels are usually lower than the peripheral blood or semen and cervical/vaginal secretions of infected-individuals.…”