Research Article
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Published Online: 1 June 2017

Estimating False-Recent Classification for the Limiting-Antigen Avidity EIA and BED-Capture Enzyme Immunoassay in Vietnam: Implications for HIV-1 Incidence Estimates

Publication: AIDS Research and Human Retroviruses
Volume 33, Issue Number 6

Abstract

Laboratory tests that can distinguish recent from long-term HIV infection are used to estimate HIV incidence in a population, but can potentially misclassify a proportion of long-term HIV infections as recent. Correct application of an assay requires determination of the proportion false recents (PFRs) as part of the assay characterization and for calculating HIV incidence in a local population using a HIV incidence assay. From April 2009 to December 2010, blood specimens were collected from HIV-infected individuals attending nine outpatient clinics (OPCs) in Vietnam (four from northern and five from southern Vietnam). Participants were living with HIV for ≥1 year and reported no antiretroviral (ARV) drug treatment. Basic demographic data and clinical information were collected. Specimens were tested with the BED capture enzyme immunoassay (BED-CEIA) and the Limiting-antigen (LAg)-Avidity EIA. PFR was estimated by dividing the number of specimens classified as recent by the total number of specimens; 95% confidence intervals (CI) were calculated. Specimens that tested recent had viral load testing performed. Among 1,813 specimens (north, n = 942 and south, n = 871), the LAg-Avidity EIA PFR was 1.7% (CI: 1.2–2.4) and differed by region [north 2.7% (CI: 1.8–3.9) versus south 0.7% (CI: 0.3–1.5); p = .002]. The BED-CEIA PFR was 2.3% (CI: 1.7–3.0) and varied by region [north 3.4% (CI: 2.4–4.7) versus south 1.0% (CI: 0.5–1.2), p < .001]. Excluding specimens with an undetectable VL, the LAg-Avidity EIA PFR was 1.2% (CI: 0.8–1.9) and the BED-CEIA PFR was 1.7% (CI: 1.2–2.4). The LAg-Avidity EIA PFR was lower than the BED-CEIA PFR. After excluding specimens with an undetectable VL, the PFR for both assays was similar. A low PFR should facilitate the implementation of the LAg-Avidity EIA for cross-sectional incidence estimates in Vietnam.

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The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Information & Authors

Information

Published In

cover image AIDS Research and Human Retroviruses
AIDS Research and Human Retroviruses
Volume 33Issue Number 6June 2017
Pages: 546 - 554
PubMed: 28193090

History

Published in print: June 2017
Published online: 1 June 2017
Published ahead of print: 13 March 2017
Published ahead of production: 14 February 2017

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Affiliations

Neha S. Shah
Centers for Disease Control and Prevention, Atlanta, Georgia.
Yen T. Duong
Centers for Disease Control and Prevention, Atlanta, Georgia.
Linh-Vi Le
Centers for Disease Control and Prevention, Hanoi, Vietnam.
Nguyen Anh Tuan
National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
Bharat S. Parekh
Centers for Disease Control and Prevention, Atlanta, Georgia.
Hoang Thi Thanh Ha
National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
Quang Duy Pham
Ho Chi Minh City Pasteur Institute, Ho Chi Minh City, Vietnam.
Cao Thi Thu Cuc
Ho Chi Minh City Pasteur Institute, Ho Chi Minh City, Vietnam.
Trudy Dobbs
Centers for Disease Control and Prevention, Atlanta, Georgia.
Tran Hong Tram
National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
Truong Thi Xuan Lien
Ho Chi Minh City Pasteur Institute, Ho Chi Minh City, Vietnam.
Nick Wagar
Centers for Disease Control and Prevention, Atlanta, Georgia.
Chunfu Yang
Centers for Disease Control and Prevention, Atlanta, Georgia.
Amy Martin
Centers for Disease Control and Prevention, Atlanta, Georgia.
Mitchell Wolfe
Centers for Disease Control and Prevention, Hanoi, Vietnam.
Nguyen Tran Hien
National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
Andrea A. Kim
Centers for Disease Control and Prevention, Atlanta, Georgia.

Notes

Address correspondence to:Neha S. ShahCenters for Disease Control and Prevention850 Marina Bay Parkway, Building P, 2nd FloorRichmond, CA 94804E-mail: [email protected]

Author Disclosure Statement

No competing financial interests exist.

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