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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Investigating the utility of the HIV-1 BED capture enzyme immunoassay using cross-sectional and longitudinal seroconverter specimens from Africa
AIDS, Volume 21, No. 4, Year 2007
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Description
BACKGROUND: The identification of populations at risk of HIV infection is a priority for trials of preventive technologies, including HIV vaccines. To quantify incidence traditionally requires laborious and expensive prospective studies. METHODS: The BED IgG-Capture enzyme immunoassay (EIA) was developed to estimate HIV-1 incidence using cross-sectional data by measuring increasing levels of HIV-specific IgG as a proportion of total IgG. To evaluate this assay, we tested 189 seroconversion samples taken at 3-monthly intervals from 15 Rwandan and 26 Zambian volunteers with known time of infection and cross-sectional specimens from 617 Kenyan and Ugandan volunteers with prevalent infection. RESULTS: The BED-EIA-estimated incidence in Uganda was unexpectedly high, at 6.1%/year [95% confidence interval (CI) 4.2-8.0] in Masaka and 6.0%/year (95% CI 4.3-7.7) in Kakira. Prospective incidence data in Masaka from the same population was 1.7%/year before and 1.4%/year after the study. Kenyan estimates were 3.5%/year in Kilifi (95% CI 2.1-4.9) and 3.4%/year in Nairobi (95% CI 1.5-5.3). From the Rwandan and Zambian data, the sensitivity of the assay was 81.2% and the specificity was 67.8%. After approximately one year, subjects misclassified as recently infected tended to have lower plasma viral loads compared with those not misclassified as recent (median copies/ml 14 773 versus 93 560; P = 0.02). Clinical presentation, sex and HIV subtype were not significantly associated with BED-EIA misclassification in seroconverter samples. CONCLUSION: These data suggest that this assay does not perform reliably in all populations. Further research is warranted before using this assay to estimate incidence from prevalent HIV samples. © 2007 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Karita, Etienne
Rwanda, Kigali
Projet San Francisco
Price, Matt A.
United States, New York
International Aids Vaccine Initiative
United States, San Mateo
International Aids Vaccine Initiative
Hunter, Eric
United States, Atlanta
Emory University
Chomba, Elwyn Nachanya
Zambia, Lusaka
Zambia-emory Hiv Research Project
Allen, Susan A.
United States, Atlanta
Emory University
Fei, Lin
United States, Newark
Pharmastat Llc
Kamali, Anatoli
United Kingdom, London
Medical Research Council
Sanders, Eduard Joachim
Kenya, Nairobi
Kenya Medical Research Institute
United Kingdom, Oxford
University of Oxford
Anzala, Aggrey Omu
Kenya, Nairobi
Kenya Aids Vaccine Initiative
Katende, Michael
Uganda, Kampala
Joint Clinical Research Center Uganda
Ketter, Nzeera
United States, New York
International Aids Vaccine Initiative
Stevens, Gwynn
Kenya, Nairobi
Kenya Aids Vaccine Initiative
Stevens, Wendy Susan
United States, New York
International Aids Vaccine Initiative
Chetty, Paramesh
United States, New York
International Aids Vaccine Initiative
Fast, Patricia E.
South Africa, Johannesburg
University of the Witwatersrand
Manigart, Olivier
Zambia, Lusaka
Zambia-emory Hiv Research Project
Birungi, Josephine
United States, New York
International Aids Vaccine Initiative
Farah, Bashir
Kenya, Nairobi
Kenya Aids Vaccine Initiative
Statistics
Citations: 123
Authors: 18
Affiliations: 12
Identifiers
Doi:
10.1097/QAD.0b013e32801481b7
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Uganda