Detection of HIV-1 in Saliva: Implications for Case-Identification, Clinical Monitoring and Surveillance for Drug Resistance§ ~!2010-04-01~!2010-04-22~!2010-05-28~!

Abstract

Background:Saliva tests that detect antibodies are used to diagnose HIV infection. The goal of this study was to determine whether saliva could be used for nucleic acid-based tests to measure HIV-1 virus load (VL) and detect drug resistance.Methods:69 HIV infected individuals provided 5-10 ml of saliva and blood samples. Viral RNA was isolated from saliva and dried blood spots using the Nuclisens extraction. Saliva VL was measured using a modified Amplicor assay, and genotyping was performed using an in-house RT-PCR/sequencing protocol. Plasma VLs were obtained from concurrently drawn clinical tests.Results:Thirty-six of 47 (77%) plasma viremic patients had measurable saliva HIV-1 RNA. Paired plasma and saliva HIV RNA levels were significantly correlated (Spearman’s correlation = .6532, p<.0001), but saliva VL was typically lower. Three of 22 patients with undetectable plasma VL (<50 copies/ml) had detectable saliva HIV RNA. Eleven of 30 patients with undetectable saliva RNA had detectable plasma HIV-1 RNA. Comparison of the protease and reverse transcriptase gene sequences from paired saliva and plasma of 20 patients showed less than 1% difference overall, and few resistance-related amino acid differencesConclusions:Most patients with plasma virus >50 copies/mL had detectable saliva HIV RNA, and the genotypic data was highly concordant between saliva and plasma. In patients with high levels of plasma HIV RNA, saliva might be useful in identifying viremia and evaluating drug resistance.

Evaluation of disease and viral biomarkers as triggers for therapeutic intervention in respiratory mousepox – An animal model of smallpox

“…Previously, PCR has been used in the detection of several different virus genomes in saliva; including HIV, dengue, CMV, influenza H1N1, and HHV-7; and in some cases PCR from saliva can be used as an early diagnostic test of infection (Balamane et al, 2010; Bilder et al, 2011; Boppana et al, 2011; Magalhaes Ide et al, 2011; Poloni et al, 2010). Therefore, we compared the time of detectable vDNA in blood with that of oropharyngeal secretions.…”

HIV-1 RNA Levels and Antiretroviral Drug Resistance in Blood and Non-Blood Compartments from HIV-1–Infected Men and Women enrolled in AIDS Clinical Trials Group Study A5077

“…Measurement of HIV RNA in the genital tract is not a convenient clinical tool, and quantification of plasma HIV RNA is used for clinical monitoring of HIV-infected subjects [4], [5]. Plasma HIV RNA correlates with viral detection in both genital fluid [6], [7], [8], [9] and saliva [10], [11]. Although anti-retroviral therapy (ART) effectively suppresses viral replication in all three compartments [9], [12], [13], [14], approximately10–40% of ART-treated subjects have detectable HIV in the genital tract fluid but not in blood plasma [6], [7], [8], [9], [15], [16], [17], [18], [19], [20], [21], [22].…”

Detection of HIV RNA in dried blood spots and oral fluids

“…Prior studies of oral fluids and saliva have shown greater yield [12-16]. HIV-1 RNA levels in oral fluids are 10- to 100-fold lower than in blood plasma [12, 13, 16] and may be less than 10,000 copies/mL, even during acute HIV-1 infection [12].…”

“…HIV-1 RNA levels in oral fluids are 10- to 100-fold lower than in blood plasma [12, 13, 16] and may be less than 10,000 copies/mL, even during acute HIV-1 infection [12]. However, in one study, HIV-1 RNA was detected in saliva of three untreated subjects who had undetectable blood plasma HIV RNA levels [16]. …”