Dual Testing Algorithm of BED-CEIA and AxSYM Avidity Index Assays Performs Best in Identifying Recent HIV Infection in a Sample of Rwandan Sex Workers 英文参考文献.docVIP

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Dual Testing Algorithm of BED-CEIA and AxSYM Avidity Index Assays Performs Best in Identifying Recent HIV Infection in a Sample of Rwandan Sex Workers 英文参考文献.doc

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Dual Testing Algorithm of BED-CEIA and AxSYM Avidity Index Assays Performs Best in Identifying Recent HIV Infection in a Sample of Rwandan Sex Workers 英文参考文献

DualTestingAlgorithmofBED-CEIAandAxSYMAvidity IndexAssaysPerformsBestinIdentifyingRecentHIV InfectioninaSampleofRwandanSexWorkers SarahL.Braunstein1*,DenisNash1,AndreaA.Kim2,KenFord3,LambertMwambarangwe3,ChantalM. Ingabire3,JosephVyankandondera3,4,JannekeH.H.M.vandeWijgert3,5 1MailmanSchoolofPublicHealth-ColumbiaUniversity,NewYork,NewYork,UnitedStatesofAmerica,2CentersforDiseaseControlandPrevention,Atlanta,Georgia, UnitedStatesofAmerica,3ProjetUbuzima,Kigali,Rwanda,4BelgianDevelopmentAgency,Kigali,Rwanda,5DepartmentofInternalMedicine,andAmsterdamInstitute forGlobalHealthandDevelopment,AcademicMedicalCenteroftheUniversityofAmsterdam,Amsterdam,TheNetherlands Abstract Background: To assess the performance of BED-CEIA (BED) and AxSYM Avidity Index (Ax-AI) assays in estimating HIV incidenceamongfemalesexworkers(FSW)inKigali,Rwanda. MethodologyandFindings:EighthundredFSWofunknownHIVstatuswereHIVtested;HIV-positivewomenhadBEDand Ax-AItestingatbaselineand$12monthslatertoestimateassayfalse-recentrates(FRR).STARHS-basedHIVincidencewas estimatedusingtheMcWalter/Welteformula,andadjustedwithlocallyderivedFRRandCD4results.HIVincidenceandlocal assaywindowperiodswereestimatedfromaprospectivecohortofFSW.Atbaseline,190HIV-positivewomenwereBED andAx-AItested;23wereclassifiedasrecentinfection(RI).AssayFRRwith95%confidenceintervalswere:3.6%(1.2–8.1) (BED);10.6%(6.1–17.0)(Ax-AI);and2.1%(0.4–6.1)(BED/Ax-AIcombined).AfterFRR-adjustment,incidenceestimatesbyBED, Ax-AI,andBED/Ax-AIwere:5.5/100person-years(95%CI2.2–8.7);7.7(3.2–12.3);and4.4(1.4–7.3).AfterCD4-adjustment, BED,Ax-AI,andBED/Ax-AIincidenceestimateswere:5.6(2.6–8.6);9.7(5.0–14.4);and4.7(2.0–7.5).HIVincidenceratesinthe firstandsecond6monthsofthecohortwere4.6(1.6–7.7)and2.2(0.1–4.4). Conclusions:AdjustedincidenceestimatesbyBED/Ax-AIcombinedweresimilartoincidenceinthefirst6monthsofthe cohort.Furthermore,false-recentrateonthecombinedBED/Ax-AIalgorithmwaslowandsubstantiallylowerthanforeither assay alone. Improved assay specificity with