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Differential specificity of HIV incidence assays in HIV subtypes A and D infected individuals from Rakai, Uganda

Background: Assays to determine HIV incidence from cross-sectional surveys have exhibited a high rate of false-recent misclassification in Kenya and Uganda where HIV subtypes A and D predominate. Methods: Samples from individuals infected with HIV for at least 2 years with known infecting subtype (1... Full description

Journal Title: AIDS research and human retroviruses 2013-08, Vol.29 (ja), p.1146-1150
Main Author: Mullis, Caroline
Other Authors: Munshaw, Supriya , Grabowski, Mary K , Eshleman, Susan H , Serwadda, David , Nalugoda, Fred , Brookmeyer, Ron , Kigozi, Godfrey , Kagaayi, Joseph , Tobian, Aaron AR , Wawer, Maria J , Gray, Ronald H , Quinn, Thomas C , Laeyendecker, Oliver
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: United States: Mary Ann Liebert, Inc
ID: ISSN: 0889-2229
Link: https://www.ncbi.nlm.nih.gov/pubmed/23641870
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title: Differential specificity of HIV incidence assays in HIV subtypes A and D infected individuals from Rakai, Uganda
format: Article
creator:
  • Mullis, Caroline
  • Munshaw, Supriya
  • Grabowski, Mary K
  • Eshleman, Susan H
  • Serwadda, David
  • Nalugoda, Fred
  • Brookmeyer, Ron
  • Kigozi, Godfrey
  • Kagaayi, Joseph
  • Tobian, Aaron AR
  • Wawer, Maria J
  • Gray, Ronald H
  • Quinn, Thomas C
  • Laeyendecker, Oliver
subjects:
  • Adult
  • AIDS/HIV
  • Cohort Studies
  • Diagnosis, Differential
  • Diagnostic Errors - statistics & numerical data
  • Female
  • HIV Infections - diagnosis
  • HIV Infections - epidemiology
  • HIV Seropositivity - epidemiology
  • HIV-1 - immunology
  • Human immunodeficiency virus
  • Humans
  • Immunoenzyme Techniques
  • Incidence
  • Male
  • Outcomes Research
  • Retrovirus
  • Sensitivity and Specificity
  • Uganda - epidemiology
ispartof: AIDS research and human retroviruses, 2013-08, Vol.29 (ja), p.1146-1150
description: Background: Assays to determine HIV incidence from cross-sectional surveys have exhibited a high rate of false-recent misclassification in Kenya and Uganda where HIV subtypes A and D predominate. Methods: Samples from individuals infected with HIV for at least 2 years with known infecting subtype (133 subtype A, 373 subtype D) were tested using the BED-CEIA and an avidity assay. Results: Both assays had a higher rate of false-recent misclassification for subtype D compared to subtype A (13.7% vs. 6.0%, p=0.02 for BED-CEIA; 11.0% vs. 1.5%, p
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0889-2229
fulltext: fulltext
issn:
  • 0889-2229
  • 1931-8405
url: Link


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titleDifferential specificity of HIV incidence assays in HIV subtypes A and D infected individuals from Rakai, Uganda
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creatorMullis, Caroline ; Munshaw, Supriya ; Grabowski, Mary K ; Eshleman, Susan H ; Serwadda, David ; Nalugoda, Fred ; Brookmeyer, Ron ; Kigozi, Godfrey ; Kagaayi, Joseph ; Tobian, Aaron AR ; Wawer, Maria J ; Gray, Ronald H ; Quinn, Thomas C ; Laeyendecker, Oliver
creatorcontribMullis, Caroline ; Munshaw, Supriya ; Grabowski, Mary K ; Eshleman, Susan H ; Serwadda, David ; Nalugoda, Fred ; Brookmeyer, Ron ; Kigozi, Godfrey ; Kagaayi, Joseph ; Tobian, Aaron AR ; Wawer, Maria J ; Gray, Ronald H ; Quinn, Thomas C ; Laeyendecker, Oliver
descriptionBackground: Assays to determine HIV incidence from cross-sectional surveys have exhibited a high rate of false-recent misclassification in Kenya and Uganda where HIV subtypes A and D predominate. Methods: Samples from individuals infected with HIV for at least 2 years with known infecting subtype (133 subtype A, 373 subtype D) were tested using the BED-CEIA and an avidity assay. Results: Both assays had a higher rate of false-recent misclassification for subtype D compared to subtype A (13.7% vs. 6.0%, p=0.02 for BED-CEIA; 11.0% vs. 1.5%, p<0.001 for avidity). For subtype D samples, false-recent misclassification by the BED-CEIA was also more frequent in women than men (15.0% vs. 5.6%, p=0.002), and in samples that had an amino acid other than lysine at position 12 in the BED-CEIA peptide coding region (p=0.002). Furthermore in subtype D infected individuals, samples misclassified by one assay were 3.5 times more likely to misclassify by the other assay. Conclusions: Differential misclassification by infecting subtype of long term infected individuals as recently infected makes it difficult to use these assays individually to estimate population level incidence without precise knowledge of the distribution of these subtypes within populations where subtype A and D co-circulate. The association of misclassification of the BED-CEIA with the avidity assay in subtype D infected individuals limits the utility of using these assays in combination within this population.
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subjectAdult ; AIDS/HIV ; Cohort Studies ; Diagnosis, Differential ; Diagnostic Errors - statistics & numerical data ; Female ; HIV Infections - diagnosis ; HIV Infections - epidemiology ; HIV Seropositivity - epidemiology ; HIV-1 - immunology ; Human immunodeficiency virus ; Humans ; Immunoenzyme Techniques ; Incidence ; Male ; Outcomes Research ; Retrovirus ; Sensitivity and Specificity ; Uganda - epidemiology
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descriptionBackground: Assays to determine HIV incidence from cross-sectional surveys have exhibited a high rate of false-recent misclassification in Kenya and Uganda where HIV subtypes A and D predominate. Methods: Samples from individuals infected with HIV for at least 2 years with known infecting subtype (133 subtype A, 373 subtype D) were tested using the BED-CEIA and an avidity assay. Results: Both assays had a higher rate of false-recent misclassification for subtype D compared to subtype A (13.7% vs. 6.0%, p=0.02 for BED-CEIA; 11.0% vs. 1.5%, p<0.001 for avidity). For subtype D samples, false-recent misclassification by the BED-CEIA was also more frequent in women than men (15.0% vs. 5.6%, p=0.002), and in samples that had an amino acid other than lysine at position 12 in the BED-CEIA peptide coding region (p=0.002). Furthermore in subtype D infected individuals, samples misclassified by one assay were 3.5 times more likely to misclassify by the other assay. Conclusions: Differential misclassification by infecting subtype of long term infected individuals as recently infected makes it difficult to use these assays individually to estimate population level incidence without precise knowledge of the distribution of these subtypes within populations where subtype A and D co-circulate. The association of misclassification of the BED-CEIA with the avidity assay in subtype D infected individuals limits the utility of using these assays in combination within this population.
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authorMullis, Caroline ; Munshaw, Supriya ; Grabowski, Mary K ; Eshleman, Susan H ; Serwadda, David ; Nalugoda, Fred ; Brookmeyer, Ron ; Kigozi, Godfrey ; Kagaayi, Joseph ; Tobian, Aaron AR ; Wawer, Maria J ; Gray, Ronald H ; Quinn, Thomas C ; Laeyendecker, Oliver
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abstractBackground: Assays to determine HIV incidence from cross-sectional surveys have exhibited a high rate of false-recent misclassification in Kenya and Uganda where HIV subtypes A and D predominate. Methods: Samples from individuals infected with HIV for at least 2 years with known infecting subtype (133 subtype A, 373 subtype D) were tested using the BED-CEIA and an avidity assay. Results: Both assays had a higher rate of false-recent misclassification for subtype D compared to subtype A (13.7% vs. 6.0%, p=0.02 for BED-CEIA; 11.0% vs. 1.5%, p<0.001 for avidity). For subtype D samples, false-recent misclassification by the BED-CEIA was also more frequent in women than men (15.0% vs. 5.6%, p=0.002), and in samples that had an amino acid other than lysine at position 12 in the BED-CEIA peptide coding region (p=0.002). Furthermore in subtype D infected individuals, samples misclassified by one assay were 3.5 times more likely to misclassify by the other assay. Conclusions: Differential misclassification by infecting subtype of long term infected individuals as recently infected makes it difficult to use these assays individually to estimate population level incidence without precise knowledge of the distribution of these subtypes within populations where subtype A and D co-circulate. The association of misclassification of the BED-CEIA with the avidity assay in subtype D infected individuals limits the utility of using these assays in combination within this population.
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