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Dual Testing Algorithm of BED-CEIA and AxSYM Avidity Index Assays Performs Best in Identifying Recent HIV Infection in a Sample of Rwandan Sex Workers

BACKGROUND: To assess the performance of BED-CEIA (BED) and AxSYM Avidity Index (Ax-AI) assays in estimating HIV incidence among female sex workers (FSW) in Kigali, Rwanda. METHODOLOGY AND FINDINGS: Eight hundred FSW of unknown HIV status were HIV tested; HIV-positive women had BED and Ax-AI testing...

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Autores principales: Braunstein, Sarah L., Nash, Denis, Kim, Andrea A., Ford, Ken, Mwambarangwe, Lambert, Ingabire, Chantal M., Vyankandondera, Joseph, van de Wijgert, Janneke H. H. M.
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075245/
https://www.ncbi.nlm.nih.gov/pubmed/21532753
http://dx.doi.org/10.1371/journal.pone.0018402
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author Braunstein, Sarah L.
Nash, Denis
Kim, Andrea A.
Ford, Ken
Mwambarangwe, Lambert
Ingabire, Chantal M.
Vyankandondera, Joseph
van de Wijgert, Janneke H. H. M.
author_facet Braunstein, Sarah L.
Nash, Denis
Kim, Andrea A.
Ford, Ken
Mwambarangwe, Lambert
Ingabire, Chantal M.
Vyankandondera, Joseph
van de Wijgert, Janneke H. H. M.
author_sort Braunstein, Sarah L.
collection PubMed
description BACKGROUND: To assess the performance of BED-CEIA (BED) and AxSYM Avidity Index (Ax-AI) assays in estimating HIV incidence among female sex workers (FSW) in Kigali, Rwanda. METHODOLOGY AND FINDINGS: Eight hundred FSW of unknown HIV status were HIV tested; HIV-positive women had BED and Ax-AI testing at baseline and ≥12 months later to estimate assay false-recent rates (FRR). STARHS-based HIV incidence was estimated using the McWalter/Welte formula, and adjusted with locally derived FRR and CD4 results. HIV incidence and local assay window periods were estimated from a prospective cohort of FSW. At baseline, 190 HIV-positive women were BED and Ax-AI tested; 23 were classified as recent infection (RI). Assay FRR with 95% confidence intervals were: 3.6% (1.2–8.1) (BED); 10.6% (6.1–17.0) (Ax-AI); and 2.1% (0.4–6.1) (BED/Ax-AI combined). After FRR-adjustment, incidence estimates by BED, Ax-AI, and BED/Ax-AI were: 5.5/100 person-years (95% CI 2.2–8.7); 7.7 (3.2–12.3); and 4.4 (1.4–7.3). After CD4-adjustment, BED, Ax-AI, and BED/Ax-AI incidence estimates were: 5.6 (2.6–8.6); 9.7 (5.0–14.4); and 4.7 (2.0–7.5). HIV incidence rates in the first and second 6 months of the cohort were 4.6 (1.6–7.7) and 2.2 (0.1–4.4). CONCLUSIONS: Adjusted incidence estimates by BED/Ax-AI combined were similar to incidence in the first 6 months of the cohort. Furthermore, false-recent rate on the combined BED/Ax-AI algorithm was low and substantially lower than for either assay alone. Improved assay specificity with time since seroconversion suggests that specificity would be higher in population-based testing where more individuals have long-term infection.
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spelling pubmed-30752452011-04-29 Dual Testing Algorithm of BED-CEIA and AxSYM Avidity Index Assays Performs Best in Identifying Recent HIV Infection in a Sample of Rwandan Sex Workers Braunstein, Sarah L. Nash, Denis Kim, Andrea A. Ford, Ken Mwambarangwe, Lambert Ingabire, Chantal M. Vyankandondera, Joseph van de Wijgert, Janneke H. H. M. PLoS One Research Article BACKGROUND: To assess the performance of BED-CEIA (BED) and AxSYM Avidity Index (Ax-AI) assays in estimating HIV incidence among female sex workers (FSW) in Kigali, Rwanda. METHODOLOGY AND FINDINGS: Eight hundred FSW of unknown HIV status were HIV tested; HIV-positive women had BED and Ax-AI testing at baseline and ≥12 months later to estimate assay false-recent rates (FRR). STARHS-based HIV incidence was estimated using the McWalter/Welte formula, and adjusted with locally derived FRR and CD4 results. HIV incidence and local assay window periods were estimated from a prospective cohort of FSW. At baseline, 190 HIV-positive women were BED and Ax-AI tested; 23 were classified as recent infection (RI). Assay FRR with 95% confidence intervals were: 3.6% (1.2–8.1) (BED); 10.6% (6.1–17.0) (Ax-AI); and 2.1% (0.4–6.1) (BED/Ax-AI combined). After FRR-adjustment, incidence estimates by BED, Ax-AI, and BED/Ax-AI were: 5.5/100 person-years (95% CI 2.2–8.7); 7.7 (3.2–12.3); and 4.4 (1.4–7.3). After CD4-adjustment, BED, Ax-AI, and BED/Ax-AI incidence estimates were: 5.6 (2.6–8.6); 9.7 (5.0–14.4); and 4.7 (2.0–7.5). HIV incidence rates in the first and second 6 months of the cohort were 4.6 (1.6–7.7) and 2.2 (0.1–4.4). CONCLUSIONS: Adjusted incidence estimates by BED/Ax-AI combined were similar to incidence in the first 6 months of the cohort. Furthermore, false-recent rate on the combined BED/Ax-AI algorithm was low and substantially lower than for either assay alone. Improved assay specificity with time since seroconversion suggests that specificity would be higher in population-based testing where more individuals have long-term infection. Public Library of Science 2011-04-12 /pmc/articles/PMC3075245/ /pubmed/21532753 http://dx.doi.org/10.1371/journal.pone.0018402 Text en Braunstein et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Braunstein, Sarah L.
Nash, Denis
Kim, Andrea A.
Ford, Ken
Mwambarangwe, Lambert
Ingabire, Chantal M.
Vyankandondera, Joseph
van de Wijgert, Janneke H. H. M.
Dual Testing Algorithm of BED-CEIA and AxSYM Avidity Index Assays Performs Best in Identifying Recent HIV Infection in a Sample of Rwandan Sex Workers
title Dual Testing Algorithm of BED-CEIA and AxSYM Avidity Index Assays Performs Best in Identifying Recent HIV Infection in a Sample of Rwandan Sex Workers
title_full Dual Testing Algorithm of BED-CEIA and AxSYM Avidity Index Assays Performs Best in Identifying Recent HIV Infection in a Sample of Rwandan Sex Workers
title_fullStr Dual Testing Algorithm of BED-CEIA and AxSYM Avidity Index Assays Performs Best in Identifying Recent HIV Infection in a Sample of Rwandan Sex Workers
title_full_unstemmed Dual Testing Algorithm of BED-CEIA and AxSYM Avidity Index Assays Performs Best in Identifying Recent HIV Infection in a Sample of Rwandan Sex Workers
title_short Dual Testing Algorithm of BED-CEIA and AxSYM Avidity Index Assays Performs Best in Identifying Recent HIV Infection in a Sample of Rwandan Sex Workers
title_sort dual testing algorithm of bed-ceia and axsym avidity index assays performs best in identifying recent hiv infection in a sample of rwandan sex workers
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075245/
https://www.ncbi.nlm.nih.gov/pubmed/21532753
http://dx.doi.org/10.1371/journal.pone.0018402
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