ArticleAIDS (London, England)2015
Targeted screening of at-risk adults for acute HIV-1 infection in sub-Saharan Africa.
Article in AIDS (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Risk-Based Screening Tools to Optimise HIV Testing Services: a Systematic Review.Current HIV/AIDS reports · 2022Pooled it
- Acute and early HIV infection screening among men who have sex with men, a systematic review and meta-analysis.Journal of the International AIDS Society · 2020Pooled it
- Systematic review of the performance and clinical utility of point of care HIV-1 RNA testing for diagnosis and care.PloS one · 2019Pooled it
- Trial
- Trial
- Trial
- Sustained Sexual Behavior Change After Acute HIV Diagnosis in Malawi.Sexually transmitted diseases · 2018Trial
- Trial
- A Four-Item Risk Score to Target Acute HIV Infection Testing Among Men Who Have Sex With Men in Indonesia: Development and Validation in the INTERACT Prospective Cohort.Journal of the International AIDS Society · 2026Article
- Public health implications of diagnosing and treating acute HIV.Current opinion in HIV and AIDS · 2025Review
- Article
- Impact of HIV self-testing for oral pre-exposure prophylaxis scale-up on drug resistance and HIV outcomes in western Kenya: a modelling study.The lancet. HIV · 2024Article
- Developing a symptoms-based risk score for infectious syphilis among men who have sex with men.Sexually transmitted infections · 2023Article
- A More Comprehensive Clinical and Laboratory Characterization of 61 Acute HIV Infection Patients in Southwest China.Pathogens (Basel, Switzerland) · 2023Article
- Phylogeographic Assessment Reveals Geographic Sources of HIV-1 Dissemination Among Men Who Have Sex With Men in Kenya.Frontiers in microbiology · 2022Article
- Predicting, Diagnosing, and Treating Acute and Early HIV Infection in a Public Sector Facility in Eswatini.Journal of acquired immune deficiency syndromes (1999) · 2021Article
- New infections and HIV-1 subtypes among febrile persons and blood donors in Oyo State, Nigeria.Journal of medical virology · 2021Article
- Peer Mobilization and Human Immunodeficiency Virus (HIV) Partner Notification Services Among Gay, Bisexual, and Other Men Who Have Sex With Men and Transgender Women in Coastal Kenya Identified a High Number of Undiagnosed HIV Infections.Open forum infectious diseases · 2021Article
- Article
- HIV infection in Eastern and Southern Africa: Highest burden, largest challenges, greatest potential.Southern African journal of HIV medicine · 2021Article
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 6 countries.
Funding
Abstract
backgroundPatients with acute HIV-1 infection (AHI) have elevated infectivity, but cannot be diagnosed using antibody-based testing. Approaches to screen patients for AHI are urgently needed to enable counselling and treatment to reduce onward transmission.
methodsWe pooled data from four African studies of high-risk adults that evaluated symptoms and signs compatible with acute retroviral syndrome and tested for HIV-1 at each visit. AHI was defined as detectable plasma viral load or p24 antigen in an HIV-1-antibody-negative patient who subsequently seroconverted. Using generalized estimating equation, we identified symptoms, signs, and demographic factors predictive of AHI, adjusting for study site. We assigned a predictor score to each statistically significant predictor based on its beta coefficient, summing predictor scores to calculate a risk score for each participant. We evaluated the performance of this algorithm overall and at each site.
resultsWe compared 122 AHI visits with 45 961 visits by uninfected patients. Younger age (18-29 years), fever, fatigue, body pains, diarrhoea, sore throat, and genital ulcer disease were independent predictors of AHI. The overall area under the receiver operating characteristics curve (AUC) for the algorithm was 0.78, with site-specific AUCs ranging from 0.61 to 0.89. A risk score of at least 2 would indicate AHI testing for 5-50% of participants, substantially decreasing the number needing testing.
conclusionOur targeted risk score algorithm based on seven characteristics reduced the number of patients needing AHI testing and had good performance overall. We recommend this risk score algorithm for use by HIV programs in sub-Saharan Africa with capacity to test high-risk patients for AHI.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.