ArticleAIDS research and human retroviruses2019
Validation of the Limiting Antigen Avidity Assay to Estimate Level and Trends in HIV Incidence in an A/D Epidemic in Rakai, Uganda.
Article in AIDS research and human retroviruses, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Use of HIV Recency Assays for HIV Incidence Estimation and Other Surveillance Use Cases: Systematic Review.JMIR public health and surveillance · 2022Pooled it
- Determination of the mean duration of recent infection and false recency rate for the HIV triplex multiplex bead assay.PloS one · 2024Article
- Adult HIV-1 incidence across 15 high-burden countries in sub-Saharan Africa from 2015 to 2019: a pooled analysis of nationally representative data.The lancet. HIV · 2023Article
- Recent HIV Infection Among Men Who Have Sex with Men, Transgender Women, and Genderqueer Individuals with Newly Diagnosed HIV Infection in Zimbabwe: Results from a Respondent-Driven Sampling Survey.AIDS research and human retroviruses · 2022Article
- A systematic review of limiting antigen avidity enzyme immunoassay for detection of recent HIV-1 infection to expand supported applications.Journal of virus eradication · 2022Review
- Article
- Performance evaluation of the Asante Rapid Recency Assay for verification of HIV diagnosis and detection of recent HIV-1 infections: Implications for epidemic control.PLOS global public health · 2022Article
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Authors and funding
10 authors.
Funding
Abstract
The limiting-antigen avidity (LAg-Avidity) assay with viral load (VL) >1,000 copies/mL is being used to estimate population-level HIV incidence in Africa. However, this has not been validated in East Africa where HIV-1 subtypes A and D circulate. Sera from persons seen in two surveys (2008-2009 and 2012-2013) limited to those who attended the previous round of the Rakai Community Cohort in Uganda were analyzed. The performance of the current LAg-Avidity protocol, with a mean duration of recent infection (MDRI) of 130 days and false recent rate (FRR) of 0%, was compared with subtype-specific MDRI and FRR, adjusted to subtype distributions. The observed incidence was 1.05/100 person years (py) [95% confidence interval (CI) 0.90-1.23] in 2008-2009 and 0.66/100 py (95% CI 0.52-0.83) in 2012-2013. In contrast, the per-protocol LAg-Avidity incidence estimates were 1.63/100 py (95% CI 0.97-2.30) in 2008-2009 and 2.55/100 py (95% CI 1.51-3.59) in 2012-2013 (a significant increase, p < .05.) However, using a subtype-specific MDRI and FRR, the subtype adjusted incidence was 0.88% (95% CI 0.44-1.33) in 2008-2009 and 0.67% (95% CI 0.00-1.68) in 2012-2013, approximating to the observed incidence trends. In this subtype A/D epidemic, the per protocol LAg-Avidity + VL assay overestimated HIV incidence and failed to detect declines in incidence. Adjustment for FRR, MDRI, and subtype distribution provided incidence estimates similar to empirically observed incidence level and trends. Thus, use of the LAg-Avidity assay in an A/D epidemic requires adjustment for subtype.
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