Details:

Alternative Title:
J Acquir Immune Defic Syndr
Publisher's site:
http://dx.doi.org/10.1097/QAI.0000000000002707
Personal Author:
Voetsch, Andrew C. ; Duong, Yen T. ; Stupp, Paul ; Saito, Suzue ; McCracken, Stephen ; ... More +
Voetsch, Andrew C. ; Duong, Yen T. ; Stupp, Paul ; Saito, Suzue ; McCracken, Stephen ; Dobbs, Trudy ; Winterhalter, Frieda S. ; Williams, Daniel B. ; Mengistu, Assegid ; Mugurungi, Owen ; Chikwanda, Prisca ; Musuka, Godfrey ; Ndongmo, Clement B. ; Dlamini, Sindisiwe ; Nuwagaba-Biribonwoha, Harriet ; Pasipamire, Munyaradzi ; Tegbaru, Belete ; Eshetu, Frehywot ; Biraro, Sam ; Ward, Jennifer ; Aibo, Dorothy ; Kabala, Andrew ; Mgomella, George S. ; Malewo, Optatus ; Mushi, Jeremiah ; Payne, Danielle ; Mengistu, Yohannes ; Asiimwe, Fred ; Shang, Judith ; Dokubo, Emily Kainne ; Eno, Laura T. ; Bissek, Anne-Cécile Zoung-Kanyi ; Kingwara, Leonard ; Junghae, Muthoni ; Kiiru, John N. ; Mwesigwa, Richard ; Balachandra, Shirish ; Lobognon, Roger ; Kampira, Elizabeth ; Detorio, Mervi ; Yufenyuy, Ernest L. ; Brown, Kristin ; Patel, Hetal K. ; Parekh, Bharat S. Less -
Description:
Background:

HIV-1 incidence calculation currently includes recency classification by HIV-1 incidence assay and unsuppressed viral load (VL≥1000 copies/mL) in a recent infection testing algorithm (RITA). However, persons with recent classification not virally suppressed and taking antiretroviral medication (ARV) may be misclassified.

Setting:

We used data from 13 African household surveys to describe the impact of an ARV-adjusted RITA on HIV-1 incidence estimates.

Methods:

HIV-seropositive samples were tested for recency using the HIV-1 Limiting Antigen (LAg)-Avidity enzyme immunoassay, HIV-1 viral load, ARVs used in each country, and ARV drug resistance. LAg-recent result was defined as normalized optical density values ≤1.5. We compared HIV-1 incidence estimates using two RITA; RITA1: LAg-recent + VL ≥1000 copies/mL and RITA2: RITA1 + undetectable ARV. We explored RITA2 with self-reported ARV use and with clinical history.

Results:

Overall, 357 adult HIV-positive participants were classified as having recent infection with RITA1. RITA2 reclassified 55 (15.4%) persons with detectable ARV as having long-term infection. Those with detectable ARV were significantly more likely to be aware of their HIV-positive status (84% vs. 10%) and had higher levels of drug resistance (74% vs. 26%) than those without detectable ARV. RITA2 incidence was lower than RITA1 incidence (range, 0%–30% decrease), resulting in decreased estimated new infections from 390,000 to 341,000 across the 13 countries. Incidence estimates were similar using detectable or self-reported ARV (R2>0.995).

Conclusions:

Including ARV in RITA2 improved the accuracy of HIV-1 incidence estimates by removing participants with likely long-term HIV infection.


Subject:
[+]
Adolescent Adult Algorithms Anti-HIV Agents Article ARV Epidemiological Monitoring Female HIV HIV-1 HIV Infections Humans Incidence Male Middle Aged RITA Surveys Viral Load Young Adult Incidence
Source:
J Acquir Immune Defic Syndr. 87(Suppl 1):S73-S80
Pubmed ID:
34166315
Pubmed Central ID:
PMC8630595
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHSUnited States/ ; PEPFAR/PEPFARUnited States/ ; U2G GH001226/GH/CGH CDC HHSUnited States/ ; U2G GH001271/GH/CGH CDC HHSUnited States/
CC999999/ImCDC/Intramural CDC HHSUnited States/ ; PEPFAR/PEPFARUnited States/ ; U2G GH001226/GH/CGH CDC HHSUnited States/ ; U2G GH001271/GH/CGH CDC HHSUnited States/ Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:5004e244c79536a6c0cec09a6046600c1fa9666e6892ee333c71239d0298b2b0
Download URL:
https://stacks.cdc.gov/view/cdc/112145/cdc_112145_DS1.pdf
File Type:

Supporting Files

• 	nihms-1751002-f0001.gif	gif
  	nihms-1751002-f0001.jpg	jpeg
  	nihms-1751002-f0002.gif	gif
  	nihms-1751002-f0002.jpg	jpeg
  	nihms-1751002.nxml	xml
  	NIHMS1751002-supplement-Supplemental_Digital_Content_1.docx	docx

More +