Incorrect identification of recent HIV infection in adults in the United States using a limiting-antigen avidity assay
Incorrect identification of recent HIV infection in adults in the United States using a limiting-antigen avidity assay
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DOI:
10.1097/qad.0000000000000221
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发表时间:
2014-05-15
期刊:
影响因子:
3.8
通讯作者:
Laeyendecker, Oliver
中科院分区:
文献类型:
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作者:
Longosz, Andrew F.;Mehta, Shruti H.;Laeyendecker, Oliver
Objectives:To evaluate factors associated with misclassification by the limiting-antigen avidity (LAg-avidity) assay among individuals with long-standing HIV infection.Design:Samples were obtained from the Multicenter AIDS Cohort Study and AIDS Linked to the IntraVenous Experience cohort (1089 samples from 667 individuals, 595 samples collected 2-4 years and 494 samples collected 4-8 years after HIV seroconversion). Paired samples from both time points were available for 422 (63.3%) of the 667 individuals.Methods:Samples were considered to be misclassified if the LAg-avidity assay result was 1.5 or less normalized optical density (OD-n) units.Results:Overall, 4.8% (52/1089) of the samples were misclassified, including 1.8% [16/884, 95% confidence interval (CI) 1.09-3.06%] of samples from individuals with viral loads above 400 copies/ml and 1.4% (10/705) of samples from individuals with viral loads above 400 copies/ml and CD4(+) cell counts above 200 cells/mu l (95% CI 0.68-2.60%). Age, race, sex, and mode of HIV acquisition were not associated with misclassification. In an adjusted analysis, viral load below 400 copies/ml [adjusted odds ratio (aOR) 3.72, 95% CI 1.61-8.57], CD4(+) cell count below 50 cells/mu l (aOR 5.41, 95% CI 1.86-15.74), and low LAg-avidity result (