ABSTRACT
The purpose of this research was to determine if the accuracy of HIV saliva and serum test results were influenced by changes in collection sites. In order to do so, serum and saliva samples were collected from 615 subjects in eight different geographic settings. The oral fluid collection/testing systems utilized were the Orapette SalivaCard HIV-1/HIV-2 antibody test (Trinity Biotech, Ireland) and the Omni-SAL/ImmunoComb II HIV 1 & 2 Saliva Test (Orgenics Ltd, Israel). For comparison, serum samples were tested by ELISA (Ortho) with reactive results confirmed via HIV-1 and HIV-2 Western blots (Biotech/Dupont, Institute Pasteur). The HIV serum and oral fluid collections were conducted in numerous test sites, which provided a great diversity in temperature, lighting and physical layout. The tests proved to be 99.8% and 100% specific, and both were 100% sensitive, regardless of the physical setting of the collections. While these systems are not currently available in the US, this study clearly demonstrates they can accurately be utilized in a variety of clinical settings, providing great promise for future applications.
Subject(s)
HIV Antibodies/analysis , HIV Infections/diagnosis , HIV-1/isolation & purification , HIV-2/isolation & purification , Saliva/immunology , AIDS Serodiagnosis , Double-Blind Method , HIV Antibodies/blood , HIV Antibodies/isolation & purification , Humans , Predictive Value of Tests , Reagent Kits, Diagnostic , Reproducibility of Results , Saliva/virology , Specimen HandlingABSTRACT
The testing of oral fluid samples for the detection of HIV antibodies offers several advantages over the testing of blood. Our objective was to evaluate a new generation of rapid and simple assays designed specifically to detect HIV-1 and HIV-2 antibodies in oral fluids (saliva). Serum and oral fluid pairs were collected from 615 high- and low-risk individuals in the United States, Peru, and the ivory Coast. Two different oral fluid collection devices and rapid assay systems included: (1) the Orapette/SalivaCard HIV-1/ HIV-2 and (2) the Omni-Sal/ImmunoCcmb II HIV-1 and HIV-2. The corresponding serum pairs were analyzed by conventional ELISAs, and all reactive sera were confirmed with HIV-1 and HIV-2 Western blots. The results indicated a 100% sensitivity for both rapid oral fluid assays, including successful detection of HIV-2 antibodies. Specificities ranged from 99.8% to 100%. One sample produced a reactive result by the SalivaCard while being nonreactive by the other assays including the Western blots. Both assays performed excellently, indicating that antibodies to HIV can be detected reliably in oral fluids by simple and rapid assays. This combination of rapid testing technology and the use of easily collected oral fluid samples offers an efficient and accurate alternative to conventional testing and can be appropriately applied to a variety of testing situations for the laboratory diagnosis of HIV infection.
Subject(s)
HIV Antibodies/analysis , HIV Infections/diagnosis , HIV-1/immunology , HIV-2/immunology , Immunoassay/methods , Saliva/immunology , Blotting, Western , Enzyme-Linked Immunosorbent Assay , Evaluation Studies as Topic , HIV Antibodies/blood , HIV Antibodies/immunology , Humans , Reagent Kits, Diagnostic , Sensitivity and SpecificityABSTRACT
Hepatitis C accounts for 20% to 40% of all acute viral hepatitis, with between 150,000 and 170,000 new cases reported in the United States each year. Approximately 50% of these patients will progress to chronicity with potential hepatic disorders. In an average dental practice that treats 20 patients each day, it is estimated that one hepatitis C patient will be encountered every 2 weeks. Because numerous dental procedures stress the immune, coagulation, and metabolic systems, a thorough understanding of the potential complications imposed by hepatitis C to these systems is essential. This case study encompasses comprehensive medical and dental management of the chronic hepatitis C patient. It includes assessment, intervention, and evaluation, as well as projected planning for future treatment.
Subject(s)
Dental Care for Disabled , Hepatitis C , Blood Coagulation Tests , Clinical Protocols , Hepatitis B/complications , Hepatitis C/complications , Hepatitis C/therapy , Humans , Male , Middle Aged , Oral Hemorrhage/prevention & control , Substance Abuse, Intravenous/complicationsABSTRACT
This article presents data regarding occurrence of hepatitis B in health care workers and children living in their households. Also reviewed are recent revisions in pediatric hepatitis B vaccine recommendations. The purpose of this discussion is twofold: to provide information to assist dental personnel in the decision-making process regarding vaccination of infants, children, and adolescents in their households; and to increase knowledge to facilitate educational presentations. In the United States from 1979 to 1989 the prevalence of new acute hepatitis B cases increased by 37 percent. An estimated 1.25 million people with chronic hepatitis B are capable of infecting those within their immediate environment, including their families. Studies indicate that dental health care workers, through occupational exposure, may have a 10 times greater risk of becoming a chronic hepatitis B carrier than the average citizen. The World Health Organizations's Expanded Programme on Immunizations recommends that children receive vaccination in populations where hepatitis B is prevalent. The three-pronged approach for reducing pediatric transmission includes: (1) vaccination of infants born to infected mothers, (2) routine vaccination of children born to hepatitis-seronegative mothers, (3) identification and vaccination of specific groups of adolescents. Comprehension of these changes may increase compliance regarding vaccination of children in our household, as well as enhancing our educational presentations to patients, the community, and professional societies.
