HIV-1 Recent Infection Testing Algorithm with Antiretroviral Drug Detection to Improve Accuracy of Incidence Estimates

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.

doi:10.1097/QAI.0000000000002707

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HIV-1 Recent Infection Testing Algorithm with Antiretroviral Drug Detection to Improve Accuracy of Incidence Estimates

8 01 2021
By Voetsch, Andrew C. ; Duong, Yen T. ; Stupp, Paul ; ...
http://dx.doi.org/10.1097/QAI.0000000000002707
Source: J Acquir Immune Defic Syndr. 87(Suppl 1):S73-S80

[PDF-630.10 KB]

English

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Details:

Alternative Title:

J Acquir Immune Defic Syndr
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.
Subjects:

[+]

Adolescent Adult Algorithms Anti-HIV Agents Epidemiological Monitoring Female HIV-1 HIV Infections Humans Incidence Male Middle Aged Young Adult
Keywords:

[+]

ARV HIV Incidence RITA Surveys Viral Load
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/ ; U2G GH001226/GH/CGH CDC HHSUnited States/ ; U2G GH001271/GH/CGH CDC HHSUnited States/ ; PEPFAR/PEPFARUnited States/

CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U2G GH001226/GH/CGH CDC HHSUnited States/ ; U2G GH001271/GH/CGH CDC HHSUnited States/ ; PEPFAR/PEPFARUnited States/ Less -
Volume:

87
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:

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	NIHMS1751002-supplement-Supplemental_Digital_Content_1.docx	docx

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