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Lewes, Delaware
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August 22, 1997     Cape Gazette
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August 22, 1997
 

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..................... 7 "  44 - CAPE GAZETTE, Friday, Aug. 22 ' Aug. 28, 1997 AIDS urine test not as rett00ble as blood tests By Kerry Kester No one is immune to Acquired Immune Deficiency Syndrome (AIDS), the deadly disease usual- ly spread through sexual contact or needle-oriented drug use. More and more people are getting tested to assure themselves that the dis- ease has not been transmitted to them or to assure their sexual part- ners that they are not carrying human immunodeficiency virus (HIV), the virus that causes AIDS. Although not marketed yet, an over-the-counter urine test may not prove a reliable manner in which to detect the presence of HIV. According to Scott Olewil- er, M.D., who specializes in infec- tious disease at Beebe Medical Center, it is possible for a urine test to show antibodies that indi- cate the presence of HIV/AIDS. However, the test may be better used as a quick screening tool than as a diagnostic tool, he said. "That will be the least accurate test I've seen," said Olewiler. The two most reliable tests, he explained, are blood or saliva tests. Urine tests, he said, have the inherent problem of a speci- men easily becoming diluted, and neither blood nor saliva are sus- ceptible to significant dilution. For example, he said, when someone drinks a lot of water, urine becomes diluted. "Urine is unpredictable," said Olewiler, "and the concentration of any- thing in it depends on how much water you've been drinking." How is AIDS tested? When physicians want to learn specifically what type of virus patients may have in their system, they can send it to a virology lab to have it cultured. Often they will learn specifically what the virus is from that process. However, the task is very diffi- cult and virology labs are limited in most areas. Therefore, it is an impractical way to detect the pres- ence of the AIDS virus. "So we look for another clue," said Olewiler. The body makes chemicals to respond to any infection that someone may have, said Olewiler. Those chemicals are called anti- bodies, and their job is to fight bacteria, viruses and anything they perceive as foreign to the body, also known as antigens. Antibodies are found in serum, he said, and they are all different. "Your serum is like a credit card," said Olewiler Like a credit card trace that shows where someone dines, shops or travels, serum shows any kind of infection a body has had. Also like the credit card spend- ing records remembered through computers, antibodies remember any infection or disease they have seen in a body's lifetime. The key for detect- ing the AIDS virus, then, he said, is looking for antibodies. "If we find the antibody, you have no OR business having that antibody unless you have the germ," said Olewiler. In 1985, he said, scien- tists began looking for antibodies that would indicate the presence of HIV. Those tests, called ELISA tests, are blood tests where serum is examined. The HIV virus, he explained, is placed on glass, and the blood serum is added to it. If antibodies chemically bond to the HIV antigens, then the test is pos- itive. If they do not adhere, the test is negative. "It's really sensitive," said Olewiler, noting that it is consid- ered about 99.9 percent accurate. Positives are retested Even when that test shows posi- tive for the presence of HIV, he said, a patient is not told immedi- ately. "We never send out results on ELISA alone," said Olewiler. Rather than take a chance of alarming a patient unnecessarily, he said, another test - if not two "Kissing causes AIDS" report misleading According to Scott Olewiler, M.D., an infectious disease spe- cialist at Beebe Medical Center, recent reports of a case of AIDS being transmitted through saliva exchanged through kissing were misleading. AIDS is transmitted through body secretions such as blood or semen. AIDS is transmitted through sexual contact - oral, anal or vaginal - with someone infected with the disease. Drug users who share needles with infected people can get the disease, babies bona to infected mothers, and people receiving blood tainted with the AIDS virus can also get the dis- ease. The media recently reported what it dubbed the first known case of the disease being transmit- ted through intimate kissing, where saliva was exchanged. Olewiler said he is concerned that people understand that the situa- tion referred to was very unusual but remained consistent with the known facts of AIDS transmis- sion. Although it is true that the virus can be, in small amounts, found in saliva, it is generally such a small amount that the body's immune system can kill it. "Kissing, he said, is not a means for AIDS transmission. In the recent case where a woman acquired the virus from her infected male partner, there were extenuating circumstances, said Olewiler. Both the male and the female, he said, had very poor oral hygiene practices, and neither had seen a dentist in many years. Both had bleeding gums, active gingivitis was present, they shared a toothbrush, and when the male flossed at night, his gums bled. Soon before the couple engaged in what they termed "deep kissing," the woman had undergone a root canal. Olewiler explained that scien- tists who have studied the case believe the transmission occurred from the oral exchange of blood. In a brochure prepared by the Centers for Disease Control, the America Responds to AIDS brochure "How You Won't Get AIDS" states people do not get AIDS from casual contact. The document states AIDS is not transmitted through mosquito or other bug bites; from hugging, clothes, telephones or toilet seats; or through saliva, sweat, tears, urine or excrement. Introducing DigiFocus, the first 100% digital hearing aid. Now the digital tech- nology that made CDs possible is available in an advanced hearing instru- ment. With its computer- ized 100% digital sound processing, DigiFocus makes millions of calcula- tions per second, con- stantly shap!ng the incom- ing sound to suit your hear- BY ing - automatically. What's more, unlike other hearing instruments, DigiFocus splits sound into seven distinct frequencies, so it can be more precisely fit to your specific hearing needs. Find out what digital technolo- gy can mean to your hearing. Call today! HEARING AID ASSOCIATES Millsboro 934-1471 Hours: Monday-Friday 9-5 p.m. Evenings Available by Appointment - 2 miles N. of Rt. 24on Rt. 30 a6 miles S. of Rt. 9 on Rt. 30 : We are the only Certified DiqiFocus Hearing, Aid Center in Delaware more - is run. The next test is called a Western blot. That test, he said, essentially "chops apart" the HIV virus with chemicals. Those parts, the anti- gens, are again blended with the serum to see if the antibodies adhere. The lab technician looks to make matches of the parts with the antibodies. He said the Western blot rarely fails to match results with ELISA. "Most people have all of them or multi-bands that are positive," he said. "There really are no false negatives," he said. "It's as close to being a perfect test as you could imagine." The saliva test is very similar in process and nearly as reliable as the blood tests, said Olewiler. There are 10 times more antibod- ies in saliva than urine, and 4,000 times more antibodies in blood than in urine. Urine tests, because they cannot be as reliable, could present prob- lems for people, he said. If they are marketed as over-the-counter pharmaceutical products similar to home pregnancy tests, people could get false readings that could devastate them. Urine tests have a far greater chance of producing false posi- tives, he said. 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