Evaluation of an HIV saliva test for the detection of HIV-1 and HIV-2 antibodies in high-risk populations in Abidjan, Cote d'Ivoire

To evaluate saliva testing in a West African field situation where both HIV-1 and HIV-2 are present, a cross-sectional study was conducted among female sex workers (FSWs) and their stable male partners (SMPs) at a STD/HIV clinic in Abidjan, Cote d'Ivoire. Saliva samples were collected with the Omni-SAL device and tested for antibodies to HIV-1 or HIV-2 by GACELISA. The HIV seroprevalence was 71% among 468 FSWs and 61% among 31 SMPs. Salivary HIV antibodies were detected in all 227 HIV-1-seropositive, in all 6 HIV-2-seropositive and in 115 of 117 dually seroreactive participants, while no salivary HIV antibodies were detected in 148 of 149 seronegative participants. The sensitivity and specificity of the saliva test were 99.4% and 99.3% respectively, and the positive and negative predictive values were 99.7% and 98.7% respectively. In this West African field situation saliva testing has a high validity compared to serum testing. The Omni-SAL and GACELISA combination is an alternative strategy to serological testing because of its high sensitivity and specificity, the ease and safety of sample collection and its relatively low cost.