testing saliva

Question

Dear Ryan,

If you can test for hiv thru saliva then why cant you become infected by saliva? Also if a person has a high viral load could saliva become infectious?

Answer

Oral testing, like HIV antibody blood testing, does not test for HIV, but for antibodies to HIV in oral fluid. An FDA approved test, called Orasure, uses a cotton fiber pad that is placed in between the gum and lower cheek for about two minutes. The collection pad collects oral mucosal transudate (OMT) -- not saliva -- because saliva does not contain enough antibodies for accurate testing. OMT is higher in HIV antibody concentration (if antibodies are present) and contains less contaminants than saliva. The pad is then placed in a preservative solution until it is tested. Standard antibody screening tests are used to determine a person's HIV status. Oral testing is considered by many sources as accurate as blood testing.

HIV can be isolated in the saliva of infected people, but in low concentrations. Saliva also contains a protective factor that renders HIV inactive. There is no epidemiologic evidence that HIV has ever been transmitted through saliva (the absence of transmission through kissing and receiving oral sex are good examples). For those reasons, it is highly unlikely that someone would get infected through saliva contact.

RMK