Recent infection testing algorithm (RITA) applied to new HIV diagnoses in England, Wales and Northern Ireland, 2009 to 2011
Recent infection testing algorithm (RITA) applied to new HIV diagnoses in England, Wales and Northern Ireland, 2009 to 2011
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DOI：
10.2807/1560-7917.es2014.19.2.20673
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发表时间：
2014-01-16
期刊：
影响因子：
19
通讯作者：
Delpech, V.
中科院分区：
文献类型：
--
作者：
Aghaizu, A.;Murphy, G.;Delpech, V.
2009年，英国公共卫生(PHE)对新的艾滋病毒诊断引入了最新感染检测算法(RITA)的常规应用，其中RITA阳性结果表明可能在前六个月获得感染。实验室将血清样本提交给PHE，使用为确定HIV抗体亲和力而改进的HIV 1/2Go AxSYM试验进行检测。结果根据亲和力指数和CD4计数、抗逆转录病毒治疗和是否存在艾滋病定义疾病的数据进行分类。2009至2011年间，英格兰、威尔士和北爱尔兰38.4%(6,966/18,134)的艾滋病毒新诊断病例接受了检测。接受测试的人的人口统计特征与所有确诊的艾滋病毒携带者相似。总体而言，男男性行为者(MSM)的新近感染率为14.7%(1,022/6,966)，高于异性恋男性和女性(7.8%，247/3,164)。年龄在15-24岁的比例高于<50岁的比例(男同性恋者31.2%(139/445)比13.6%(42/308)；异性恋男女17.3%(43/249)比6.2%(31/501))。在异性恋男性和女性中，与白人相比，非洲黑人最近感染的可能性最小(4.8%，90/1892比13.3%，97/728；调整后的优势比：0.6；95%可信区间：0.4-0.9)。我们的结果表明，在研究期间，特别是在男男性接触者中，有证据表明艾滋病毒正在传播。
In 2009, Public Health England (PHE) introduced the routine application of a recent infection testing algorithm (RITA) to new HIV diagnoses, where a positive RITA result indicates likely acquisition of infection in the previous six months. Laboratories submit serum specimens to PHE for testing using the HIV 1/2gO AxSYM assay modified for the determination of HIV antibody avidity. Results are classified according to avidity index and data on CD4 count, antiretroviral treatment and the presence of an AIDS-defining illness. Between 2009 and 2011, 38.4% (6,966/18,134) of new HIV diagnoses in England, Wales and Northern Ireland were tested. Demographic characteristics of those tested were similar to all persons with diagnosed HIV. Overall, recent infection was 14.7% (1,022/6,966) and higher among men who have sex with men (MSM) (22.3%, 720/3,223) compared with heterosexual men and women (7.8%, 247/3,164). Higher proportions were among persons aged 15-24 years compared with those >= 50 years (MSM 31.2% (139/445) vs 13.6% (42/308); heterosexual men and women 17.3% (43/249) vs 6.2% (31/501)). Among heterosexual men and women, black Africans were least likely to have recent infection compared with whites (4.8%, 90/1,892 vs 13.3%, 97/728; adjusted odds ratio: 0.6; 95% CI: 0.4-0.9). Our results indicate evidence of ongoing HIV transmission during the study period, particularly among MSM.