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Kathryn Ryder, MD
University of Nevada School of Medicine Las Vegas

JAMA. 1997;277(20):1591.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The article by Ms Gallo and colleagues¹ on an oral mucosal transudate (OMT) system for human immunodeficiency virus type 1 (HIV-1) antibody testing cites sensitivity as an important characteristic of this type of test. The authors demonstrate that in the general population this test will perform well, with a negative predictive value of 99.9%. Little disease will escape undetected.

However, the general population has a much lower prevalence of HIV than their study population, in which 673 of 3570 subjects were positive for disease. The positive predictive value of the enzyme immunoassay (EIA) component of this test decreases from 97.5% in their sample to only 40% when applied to the general population. The OMT Western blot performs better, since none of the 2897 HIV-negative subjects in the study had a positive Western blot test result. Some still had an indeterminate test result, though, so the positive . . . [Full Text PDF of this Article]

Footnotes
Edited by Margaret A. Winker, MD, Senior Editor, and Phil B. Fontanarosa, MD, Senior Editor.

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