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Free Content The validity of HIV testing using sputum from suspected tuberculosis patients, Botswana, 2001

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SETTING: 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.

DESIGN: 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 manufacturerÕs 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.

Keywords: Botswana; human immunodeficiency virus; surveillance; tuberculosis

Document Type: Regular Paper

Affiliations: 1: BOTUSA Project, Division of Tuberculosis Elimination, NCHSTP, Centers for Disease Control and Prevention (CDC), Dulles, Virginia, USA 2: Ministry of Health, Gaborone, Botswana 3: National Health Laboratory, Ministry of Health, Gaborone, Botswana 4: Global AIDS Program, NCHSTP, CDC, Atlanta, Georgia, USA

Publication date: August 1, 2003

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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