Can HIV incidence testing be used for evaluating HIV intervention programs? A reanalysis of the Orange Farm male circumcision trial (ANRS-1265).
Can HIV incidence testing be used for evaluating HIV intervention programs? A reanalysis of the Orange Farm male circumcision trial (ANRS-1265).
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DOI：
10.1186/1471-2334-10-137
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发表时间：
2010-05-27
影响因子：
3.7
通讯作者：
Auvert B
中科院分区：
文献类型：
--
作者：
Fiamma A;Lissouba P;Amy OE;Singh B;Laeyendecker O;Quinn TC;Taljaard D;Auvert B
本研究的目的是评估男性包皮环切术 (MC) 对使用 HIV 发病率测定估计出的 HIV 感染的影响，并将其与生存分析测量的效果进行比较。我们使用了在 Orange Farm（南非）针对 18 至 24 岁男性进行的 MC 随机对照试验 (ANRS-1265) 期间收集的样本。在上次随访时收集的 2946 个样本中，使用两种发病率测定法对 194 个 HIV 阳性样本进行了检测：Calypte HIV-EIA (BED) 和基于 BioRad HIV1/2+O EIA (AI) 的亲和力测定法。分析结果也被合并（BED-AI）。样本包括 124 名随机艾滋病毒阳性的参与者（占总数的 4.2%）。保护效果计算为一减去意向治疗发生率比率，以未校正的方式和错误分类的校正，用简单的理论公式计算。理论计算表明，未校正的意向治疗效果大致独立于发病率测定窗口期的值，并且是随机分组之间测试的近期血清转化者人数除以测试的 HIV 阴性人数的比率。我们使用 BED 的截止值范围为 0.325 至 2.27，AI 的截止值范围为 31.6 至 96，BED-AI 的截止值范围为 0.325-31.6 至 1.89-96。使用先前发布的公式对长期特异性的效果进行了校正。 95% 置信区间 (CI) 通过自举重采样估计。在最高截止值下，BED、AI 和 BED-AI 评估的未校正保护效果分别为 50%（95%CI：27% 至 66%）、50%（21% 至 69%）和 63%（36% 至 81%）。错误分类的纠正率低于近期测试数量的 50%。校正效果分别为53%（30%至70%）、55%（25%至77%）和67%（38%至86%），略高于相应的未校正值。这些值与先前报道的生存分析获得的 60%（34% 至 76%）保护效果一致。 HIV 发病率测定可用于使用横截面数据评估干预措施的效果。
The objective of this study was to estimate the effect of male circumcision (MC) on HIV acquisition estimated using HIV incidence assays and to compare it to the effect measured by survival analysis. We used samples collected during the MC randomized controlled trial (ANRS-1265) conducted in Orange Farm (South Africa) among men aged 18 to 24. Among the 2946 samples collected at the last follow-up visit, 194 HIV-positive samples were tested using two incidence assays: Calypte HIV-EIA (BED) and an avidity assay based on the BioRad HIV1/2+O EIA (AI). The results of the assays were also combined (BED-AI). The samples included the 124 participants (4.2% of total) who were HIV-positive at randomization. The protective effect was calculated as one minus the intention-to-treat incidence rate ratio in an uncorrected manner and with correction for misclassifications, with simple theoretical formulae. Theoretical calculations showed that the uncorrected intention-to-treat effect was approximately independent of the value of the incidence assay window period and was the ratio of the number tested recent seroconverters divided by the number tested HIV-negative between the randomization groups. We used cut-off values ranging from 0.325 to 2.27 for BED, 31.6 to 96 for AI and 0.325-31.6 to 1.89-96 for BED-AI. Effects were corrected for long-term specificity using a previously published formula. 95% Confidence intervals (CI) were estimated by bootstrap resampling. With the highest cut-off values, the uncorrected protective effects evaluated by BED, AI and BED-AI were 50% (95%CI: 27% to 66%), 50% (21% to 69%) and 63% (36% to 81%). The corrections for misclassifications were lower than 50% of the number of tested recent. The corrected effects were 53% (30% to 70%), 55% (25% to 77%) and 67% (38% to 86%), slightly higher than the corresponding uncorrected values. These values were consistent with the previously reported protective effect of 60% (34% to 76%) obtained with survival analysis. HIV incidence assays may be employed to assess the effect of interventions using cross-sectional data.
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DOI：
10.1097/qai.0b013e3181b327e7
发表时间：
2010-01-01
影响因子：
3.6
作者：
Auvert, Bertran;Lissouba, Pascale;Taljaard, Dirk
通讯作者：
Taljaard, Dirk
影响因子：
1.9
作者：
McWalter, Thomas Andrew;Welte, Alex
通讯作者：
Welte, Alex
影响因子：
3.8
作者：
Brookmeyer, Ron
通讯作者：
Brookmeyer, Ron
影响因子：
3.7
作者：
Bärnighausen T;Wallrauch C;Welte A;McWalter TA;Mbizana N;Viljoen J;Graham N;Tanser F;Puren A;Newell ML
通讯作者：
Newell ML
影响因子：
1.5
作者：
Parekh, BS;Kennedy, MS;McDougal, JS
通讯作者：
McDougal, JS