Updated from 2:24 p.m. EDTShares of OraSure Technologies ( OSUR) were among the worst-performing health and pharmaceutical stocks Wednesday after the company posted break-even earnings on stronger-than-expected sales but warned that it may not attain full-year profitability. The diagnostics company reported break-even earnings on sales of $13.2 million. Analysts polled by Thomson First Call had expected it to post a loss of 1 cent a share on sales of $12.8 million. Looking ahead, it forecast full-year sales of $51.5 million to $52.5 million but said that its ability to turn a profit for the year is "now a bit more uncertain." Additional expenses and patent litigation "will make it difficult to achieve full-year profitability in 2004," the company said. Analysts were looking for earnings of 2 cents a share for the year on sales of $51.8 million. Shares of OraSure Technologies traded down $1.42, or 19.3%, to $5.93. Impax Laboratories ( IPXL) fell after it posted weaker-than-expected second-quarter earnings. The pharmaceutical company earned a penny a share on sales of $30.8 million. Analysts were looking for earnings of 3 cents a share on sales of $30.6 million. A year ago it posted a loss of 5 cents a share on sales of $14.1 million. Impax Laboratories shares traded down $1.97, or 14.1%, to $12. Shares of Reliv International ( RELV) rose after the company posted in-line second-quarter earnings on better-than-expected sales. The marketer of nutritional supplements posted earnings of 8 cents a share on sales of $23.9 million. Analysts were looking for 8 cents a share on sales of $21.4 million. A year ago it posted earnings of 6 cents a share on sales of $17.8 million. Shares of Reliv International traded up $1.15, or 16.1%, to $8.28. Nanogen ( NGEN) fell after it posted a second-quarter loss on declining sales. The San Diego-based biotechnology diagnostics company posted a loss of 38 cents a share on sales of $1.1 million. A year ago it reported a loss of 32 cents a share on sales of $1.7 million. This year's second quarter included an inventory reserve charge of $1.5 million and a research and development writeoff of $3.8 million. Looking ahead, Nanogen said it does not expect a sales increase for 2004 vs. 2003. Shares of Nanogen traded down 99 cents, or 20.6%, to $3.81.