ArticlePloS one2016
Estimation of the Undiagnosed Intervals of HIV-Infected Individuals by a Modified Back-Calculation Method for Reconstructing the Epidemic Curves.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis 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
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of models used to estimate undiagnosed HIV prevalence in high-income low-prevalence countries and territories.AIDS (London, England) · 2026Pooled it
- Late HIV Presentation Remains High in Korea: 28-Year National Surveillance Trends and the Limits of Inference under Incomplete CD4 Capture, 1998-2025.Infection & chemotherapy · 2026Article
- Effectiveness and safety of community-led assisted partner service among HIV-diagnosed men who have sex with men: a multicentre, randomized controlled trial in China.The Lancet regional health. Western Pacific · 2023Article
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- Incorporation of information diffusion model for enhancing analyses in HIV molecular surveillance.Emerging microbes & infections · 2020Article
- The Continuing Value of CD4 Cell Count Monitoring for Differential HIV Care and Surveillance.JMIR public health and surveillance · 2019Article
- Pre-exposure prophylaxis (PrEP) for MSM in low HIV incidence places: should high risk individuals be targeted?Scientific reports · 2018Article
- People living with undiagnosed HIV infection and a low CD4 count: estimates from surveillance data, Italy, 2012 to 2014.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2018Article
- HIV-1 Viral Loads Are Not Elevated in Individuals Co-infected WithFrontiers in immunology · 2018Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundUndiagnosed infections accounted for the hidden proportion of HIV cases that have escaped from public health surveillance. To assess the population risk of HIV transmission, we estimated the undiagnosed interval of each known infection for constructing the HIV incidence curves.
methodsWe used modified back-calculation methods to estimate the seroconversion year for each diagnosed patient attending any one of the 3 HIV specialist clinics in Hong Kong. Three approaches were used, depending on the adequacy of CD4 data: (A) estimating one's pre-treatment CD4 depletion rate in multilevel model;(B) projecting one's seroconversion year by referencing seroconverters' CD4 depletion rate; or (C) projecting from the distribution of estimated undiagnosed intervals in (B). Factors associated with long undiagnosed interval (>2 years) were examined in univariate analyses. Epidemic curves constructed from estimated seroconversion data were evaluated by modes of transmission.
resultsBetween 1991 and 2010, a total of 3695 adult HIV patients were diagnosed. The undiagnosed intervals were derived from method (A) (28%), (B) (61%) and (C) (11%) respectively. The intervals ranged from 0 to 10 years, and were shortened from 2001. Heterosexual infection, female, Chinese and age >64 at diagnosis were associated with long undiagnosed interval. Overall, the peaks of the new incidence curves were reached 4-6 years ahead of reported diagnoses, while their contours varied by mode of transmission. Characteristically, the epidemic growth of heterosexual male and female declined after 1998 with slight rebound in 2004-2006, but that of MSM continued to rise after 1998.
conclusionsBy determining the time of seroconversion, HIV epidemic curves could be reconstructed from clinical data to better illustrate the trends of new infections. With the increasing coverage of antiretroviral therapy, the undiagnosed interval can add to the measures for assessing HIV transmission risk in the population.
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