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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Improved HIV-1 incidence estimates using the BED capture enzyme immunoassay
AIDS, Volume 22, No. 4, Year 2008
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Description
OBJECTIVE: To validate the BED capture enzyme immunoassay for HIV-1 subtype C and to derive adjustments facilitating estimation of HIV-1 incidence from cross-sectional surveys. DESIGN: Laboratory analysis of archived plasma samples collected in Zimbabwe. METHODS: Serial plasma samples from 85 women who seroconverted to HIV-1 during the postpartum year were assayed by BED and used to estimate the window period between seroconversion and the attainment of a specified BED absorbance. HIV-1 incidences for the year prior to recruitment and for the postpartum year were calculated by applying the BED technique to HIV-1-positive samples collected at baseline and at 12 months. RESULTS: The mean window for an absorbance cut-off of 0.8 was 187 days. Among women who were HIV-1 positive at baseline and retested at 12 months, a proportion (ε) 5.2% (142/2749) had a BED absorbance < 0.8 at 12 months and were falsely identified as recent seroconverters. Consequently, the estimated BED annual incidence at 12 months postpartum (7.6%) was 2.2 times the contemporary prospective estimate. BED incidence adjusted for ε was 3.5% [95% confidence interval (CI), 2.6-4.5], close to the 3.4% estimated prospectively. Adjusted BED incidence at baseline was 6.0% (95% CI, 5.2-6.9) and, like the prospective estimates, declined with maternal age. Unadjusted BED incidence estimates were largely independent of age; the pooled estimate was 58% higher than adjusted incidence. CONCLUSION: The BED method can be used in an African setting, but further estimates of ε and of the window period are required, using large samples in a variety of circumstances, before its general utility can be gauged. © 2008 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Hargrove, John W.
Zimbabwe, Harare
Zvitambo Project
South Africa, Stellenbosch
Stellenbosch University
Humphrey, Jean H.
Zimbabwe, Harare
Zvitambo Project
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Zimbabwe, Harare
Zvitambo
Mutasa, Kuda E.
Zimbabwe, Harare
Zvitambo Project
Parekh, Bharat S.
United States, Atlanta
Centers for Disease Control and Prevention
McDougal, John Steven
United States, Atlanta
Centers for Disease Control and Prevention
Ntozini, Robert
Zimbabwe, Harare
Zvitambo Project
Chidawanyika, Henry
Zimbabwe, Harare
Zvitambo Project
Moulton, Lawrence H.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Ward, Brian James
Canada, Montreal
Mcgill University Health Centre, Montreal General Hospital
Nathoo, Kusum Jackison
Zimbabwe, Harare
University of Zimbabwe
Iliff, Peter J.
Zimbabwe, Harare
Zvitambo Project
Kopp, Ekkehard
South Africa, Stellenbosch
Stellenbosch University
Statistics
Citations: 158
Authors: 12
Affiliations: 7
Identifiers
Doi:
10.1097/QAD.0b013e3282f2a960
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Zimbabwe
Participants Gender
Female