Detection of anti-HIV in saliva and urine at the time of seroconversion.

To determine whether there is a delay between the appearance of anti-HIV in serum/plasma and its detection in saliva and urine, salivary and urine specimens were collected from nine individuals who, on the basis of increasing IgG anti-HIV reactivity, Western blot band patterns and presence of strong IgM anti-HIV reactivity in their serum specimens, were believed to have recently become anti-HIV-positive. Serum from 8 of these patients and 3 commercial panels of plasma specimens collected during seroconversion were diluted to mimic the low immunoglobulin concentrations present in saliva and urine and tested in Wellcozyme HIV 1 + 2 GACELISA and four commercial EIAs intended for testing serum specimens. The 9 pairs of saliva and urine specimens were collected between 4 and 43 days (median 24 days) after the first evidence of seroconversion. All were reactive by Wellcozyme HIV 1 + 2 GACELISA and gave optical density/cut off (OD/CO) ratios in the range 3.8 to 9.8 (median 5.2) for dribbled saliva and 2.4 to 10.1 (median 6.3) for urine. Salivary specimens taken with commercial collection devices gave OD/CO ratios in the range 1.6 to 10.6 (median 5.9). In the serum/plasma specimens Wellcozyme HIV 1 + 2 GACELISA detected anti-HIV at higher dilutions than the other assays, often with a 100-fold or more difference. Saliva and urine specimens were all strongly reactive by Wellcozyme HIV 1 + 2 GACELISA. We therefore predict that it would first detect anti-HIV in salivary and urine specimens at about the same time as it becomes detectable in serum/plasma but that other commercial EIAs would not.