Detection of HIV-1 Antibodies in Saliva of Persons Living With HIV Using Blood-Based First Response HIV 1-2.O Card Test

Background: This study tested HIV-1 antibodies in saliva samples (sHIV-1 Ab) collected by the Self-Lollisponge device. Methods: Blood and saliva from confirmed persons with HIV and HIV-negative controls were analyzed for HIV-1/2 antibodies using the blood-based First Response HIV 1-2.O Card Test. The sampling device containing sHIV-1 Ab was stored at 6 degrees C for 60 days, with intermittent testing on days 2, 5, 10, 20, 30, and 60. Regression analysis was done to assess the relationship between the presence of sHIV-1 Ab and independent variables. Results: The sensitivity and the specificity of detecting sHIV-1 Ab were 72.9% (95% CI: 63.92%-80.65%) and 100% (95% CI: 92.89%-100.00%), respectively. The presence of opportunistic infections (AOR = 13.1, p < 0.001), having stomatorrhagia (AOR = 4.56, p = 0.0022), and hyperviremia (> 201 copies/mL) (AOR = 4.91, p = 0.0225) heightened sHIV-1 Ab detection. Furthermore, fatigue (AOR = 12.1, p = 0.0024), fever (AOR = 3.5, p = 0.0144), and weight loss (AOR = 10.9, p = 0.0318) increased the odds of having sHIV-1 Ab in persons living with HIV (PLWHIV). sHIV-1 Ab was identified in over 90% of PLWHIV with opportunistic infections (OIs) and stomatorrhagia, OIs and hyperviremia, and stomatorrhagia and hyperviremia. Upon storage for 60 days, the sHIV-1 Ab was detected in all the samples. Conclusion: Saliva could be an alternative to blood for diagnosing HIV. In addition, the Self-Lollisponge device was found to be user-friendly, acquiescent to all settings, and cheap, and can preserve sHIV-1 Ab for at least 60 days.