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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Evaluation of the false recent classification rates of multiassay algorithms in estimating HIV type 1 subtype C incidence
AIDS Research and Human Retroviruses, Volume 30, No. 1, Year 2014
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Description
Laboratory cross-sectional assays are useful for the estimation of HIV incidence, but are known to misclassify individuals with long-standing infection as recently infected. The false recent rate (FRR) varies widely across geographic areas; therefore, accurate estimates of HIV incidence require a locally defined FRR. We determined FRR for Botswana, where HIV-1 subtype C infection is predominant, using the BED capture enzyme immunoassay (BED), a Bio-Rad Avidity Index (BAI) assay (a modification of the Bio-Rad HIV1/2+O EIA), and two multiassay algorithms (MAA) that included clinical data. To estimate FRR, stored blood samples from 512 antiretroviral (ARV)-naive HIV-1 subtype C-infected individuals from a prospective cohort in Botswana were tested at 18-24 months postenrollment. The following FRR mean (95% CI) values were obtained: BED 6.05% (4.15-8.48), BAI 5.57% (3.70-8.0), BED-BAI 2.25% (1.13-4.0), and a combination of BED-BAI with CD4 (>200) and viral load (>400) threshold 1.43% (0.58-2.93). The interassay agreement between BED and BAI was 92.8% (95% CI, 90.1-94.5) for recent/long-term classification. Misclassification was associated with viral suppression for BED [adjusted OR (aOR) 10.31; p=0.008], BAI [aOR 9.72; p=0.019], and MAA1 [aOR 16.6; p=0.006]. Employing MAA can reduce FRR to <2%. A local FRR can improve cross-sectional HIV incidence estimates. © 2014, Mary Ann Liebert, Inc.
Authors & Co-Authors
Moyo, Sikhulile M.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
South Africa, Stellenbosch
Stellenbosch University
LeCuyer, Tessa
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Pullman
Washington State University Pullman
Wang, Rui
United States, Boston
Harvard T.h. Chan School of Public Health
United States, Boston
Brigham and Women's Hospital
Gaseitsiwe, Simani
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Weng, Jia
United States, Boston
Brigham and Women's Hospital
Musonda, Rosemary Mubanga
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Bussmann, Hermann
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Mine, Madisa O.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Botswana, Gaborone
National Health Laboratory and Botswana-harvard Hiv Reference Laboratory
Engelbrecht, Susan
South Africa, Stellenbosch
Stellenbosch University
South Africa, Johannesburg
National Health Laboratory Service
Makhema, Joseph M.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Marlink, Richard G.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Baum, Marianna Karas
United States, Miami
Florida International University
Novitsky, Vladimir A.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Essex, Myron E.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Statistics
Citations: 17
Authors: 14
Affiliations: 8
Identifiers
Doi:
10.1089/aid.2013.0055
ISSN:
08892229
e-ISSN:
19318405
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Botswana