The validity of HIV testing using sputum from suspected tuberculosis patients, Botswana, 2001.
METHODS
The World Health Organization recommends that sentinel HIV surveillance be conducted on tuberculosis patients. However, serum HIV testing is complicated in the TB clinic context, and may not be acceptable to patients.


METHODS
To determine the utility of the OraQuick HIV-1/2 Assay for the detection of HIV antibodies in sputum, we consecutively enrolled adult in-patients in Botswana who had sputum sent for acid-fast bacilli testing and serum sent for HIV ELISA testing. OraQuick HIV-1/2 Assay was applied to gingival secretions according to manufacturer's guidelines, and was also dipped into sputum specimens. A subset of 60 sputum specimens was also serially tested up to 72 hours after collection.


RESULTS
Of 377 patients, 84% were HIV-positive by serum ELISA. Compared with serum ELISA, the OraQuick HIV-1/2 Assay detected HIV in gingival secretions with 98.4% sensitivity and 98.3% specificity (95%CI 97-99 and 92-100, respectively), and 97.1% sensitivity and 98.3% specificity on initial sputum specimens (95%CI 95-99 and 92-100, respectively). OraQuick HIV-1/2 Assay performance on sputum declined slightly when tested up to 72 hours after collection.


CONCLUSIONS
When applied to sputum specimens, the OraQuick HIV-1/2 Assay demonstrates sensitivity and specificity comparable to its intended application on gingival secretions. This novel testing method will be valuable in anonymous sentinel HIV surveillance surveys among tuberculosis patients.
Talbot
E A
EA
BOTUSA Project, Division of Tuberculosis Elimination, NCHSTP, Centers for Disease Control and Prevention (CDC), Dulles, Virginia, USA.
Hone
N M
NM
Moffat
H J
HJ
Lee
E J
EJ
Moeti
T L
TL
Mokobela
K
K
Mbulawa
M
M
Binkin
N J
NJ
Wells
C D
CD
Kenyon
T A
TA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001902:Botswana; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D017408:Guidelines as Topic; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis*; D015497:HIV-1 / Q000276:immunology*; D015498:HIV-2 / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology* / Q000302:isolation & purification; D011159:Population Surveillance; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology*; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis*; D014944:World Health Organization
D011933:Reagent Kits, Diagnostic