HIV incidence in rural South Africa: comparison of estimates from longitudinal surveillance and cross-sectional cBED assay testing.
HIV incidence in rural South Africa: comparison of estimates from longitudinal surveillance and cross-sectional cBED assay testing.
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DOI：
10.1371/journal.pone.0003640
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发表时间：
2008
期刊：
影响因子：
3.7
通讯作者：
Newell ML
中科院分区：
文献类型：
--
作者：
Bärnighausen T;Wallrauch C;Welte A;McWalter TA;Mbizana N;Viljoen J;Graham N;Tanser F;Puren A;Newell ML
BED igg捕获酶免疫测定法（cBED）是一种检测近期HIV感染的方法，在HIV横断面调查中用于估计HIV发病率。然而，由于错误地将一些非最近感染艾滋病毒的个体分类为最近感染艾滋病毒的个体，因此有人担心该检测在未知程度上高估了艾滋病毒的发病率。我们使用来自南非农村HIV纵向监测的数据来测量被cBED检测（长期假阳性比（FPR））错误分类为近期HIV感染的非近期HIV感染者的比例，并将基于cBED检测的HIV发病率估计值与纵向测量的HIV发病率进行比较。我们测量了两次HIV检测呈阳性的个体的长期FPR（在2003-2006年HIV监测中），间隔超过306天（样本量n = 1,065）。我们实施了四种不同的公式来计算使用cBED检测的HIV发病率（n = 11,755），并通过直接计算发病率值的中央第95百分位数获得置信区间（ci）。我们观察了4,869个人超过7,685人年的纵向HIV发病率估计。长期FPR为0.0169 （95% CI 0.0100-0.0266）。使用该FPR，根据发病率公式，基于cbd的横断面HIV发病率估计（每100人每年）在3.03 （95% CI 2.44-3.63）和3.19 （95% CI 2.57-3.82）之间变化。使用基于先前研究的长期FPR为0.0560，HIV发病率估计值在0.65 （95% CI 0.00-1.32）和0.71 （95% CI 0.00-1.43）之间变化。在对基于cBED分析的估计中使用的样本的性别年龄分布进行调整后，纵向测量的HIV发病率为每年3.09 / 100人（95% CI 2.69-3.52）。在南非艾滋病毒高流行率的农村社区，cBED检测的长期FPR大大低于以前的估计。如果使用当地测量的长期FPR， cBED分析在HIV发病率估计方面表现良好，但当使用基于其他环境中先前研究的FPR估计时，cBED分析明显低估了发病率。
The BED IgG-Capture Enzyme Immunoassay (cBED assay), a test of recent HIV infection, has been used to estimate HIV incidence in cross-sectional HIV surveys. However, there has been concern that the assay overestimates HIV incidence to an unknown extent because it falsely classifies some individuals with non-recent HIV infections as recently infected. We used data from a longitudinal HIV surveillance in rural South Africa to measure the fraction of people with non-recent HIV infection who are falsely classified as recently HIV-infected by the cBED assay (the long-term false-positive ratio (FPR)) and compared cBED assay-based HIV incidence estimates to longitudinally measured HIV incidence. We measured the long-term FPR in individuals with two positive HIV tests (in the HIV surveillance, 2003–2006) more than 306 days apart (sample size n = 1,065). We implemented four different formulae to calculate HIV incidence using cBED assay testing (n = 11,755) and obtained confidence intervals (CIs) by directly calculating the central 95th percentile of incidence values. We observed 4,869 individuals over 7,685 person-years for longitudinal HIV incidence estimation. The long-term FPR was 0.0169 (95% CI 0.0100–0.0266). Using this FPR, the cross-sectional cBED-based HIV incidence estimates (per 100 people per year) varied between 3.03 (95% CI 2.44–3.63) and 3.19 (95% CI 2.57–3.82), depending on the incidence formula. Using a long-term FPR of 0.0560 based on previous studies, HIV incidence estimates varied between 0.65 (95% CI 0.00–1.32) and 0.71 (95% CI 0.00–1.43). The longitudinally measured HIV incidence was 3.09 per 100 people per year (95% CI 2.69–3.52), after adjustment to the sex-age distribution of the sample used in cBED assay-based estimation. In a rural community in South Africa with high HIV prevalence, the long-term FPR of the cBED assay is substantially lower than previous estimates. The cBED assay performs well in HIV incidence estimation if the locally measured long-term FPR is used, but significantly underestimates incidence when a FPR estimate based on previous studies in other settings is used.
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影响因子：
6.1
作者：
Li Shen-Wei;Zhang Xiao-Yan;Shao Yi-Ming
通讯作者：
Shao Yi-Ming
影响因子：
3.8
作者：
Barnighausen, Till;Tanser, Frank;Newell, Marie-Louise
通讯作者：
Newell, Marie-Louise
影响因子：
1.5
作者：
Parekh, BS;Kennedy, MS;McDougal, JS
通讯作者：
McDougal, JS
影响因子：
9.4
作者：
Loschen, Stephan;Baetzing-Feigenbaum, Joerg;Kuecherer, Claudia
通讯作者：
Kuecherer, Claudia
影响因子：
1.5
作者：
McDougal, J. Steven;Parekh, Bharat S.;Gurwith, Marc
通讯作者：
Gurwith, Marc