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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Identification of primary HIV-1C infection in Botswana
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Volume 20, No. 7, Year 2008
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Description
Methods for identification of primary HIV infections seem increasingly important to understand pathogenesis, and to prevent transmission, which is particularly efficient during acute infection. Most current algorithms for HIV testing are based on detection of HIV antibodies and are unable to identify early infections before seroconversion. The efficiency of prospective cohorts, which is a standard approach for identifying primary HIV-1 infection, depends on a variety of epidemiological and cultural factors including HIV incidence and stigma and, not surprisingly, varies significantly in different geographical areas. We report a voluntary counseling and testing (VCT)-based approach to identifying primary HIV-1C infection that was developed as part of a primary HIV-1 subtype C infection study in Botswana. The referral strategy was based on: (1) collaboration with VCT centers at city clinics operated by the Ministry of Health; (2) partnering with the busiest non-government VCT center; (3) educating healthcare workers and the community about primary HIV infection; and (4) pairing with diverse VCT providers, including NGOs and private-sector organizations. Acute HIV-1 infections were defined by a negative HIV-1 serology combined with a positive HIV-1 RT-PCR test. Recent HIV-1 infections were identified by detuned EIA testing according to the classic STARTH algorithm. The VCT-based referral strategy resulted in the successful identification of 57 cases of acute and early HIV infection. A referral strategy of expanded VCT with viral RNA (Ribonucleic acid) testing to a national program in Botswana may be a promising approach for identification of primary HIV infections on a countrywide level. The program should offer VCT with viral RNA testing to the general public, facilitate proper counseling and risk reduction, and allow initiation of early HAART, and may reduce new viral transmissions. © 2008 Taylor & Francis.
Authors & Co-Authors
Novitsky, Vladimir A.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Woldegabriel, Elias
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Wester, Carolyn William
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
McDonald, E.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Rossenkhan, Raabya
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Ketunuti, Melissa
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Makhema, Joseph M.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Seage, George R.
United States, Boston
Harvard T.h. Chan School of Public Health
Essex, Max E.
United States, Boston
Harvard T.h. Chan School of Public Health
Statistics
Citations: 36
Authors: 9
Affiliations: 2
Identifiers
Doi:
10.1080/09540120701694055
ISSN:
09540121
e-ISSN:
13600451
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Locations
Botswana