ArticleAIDS research and human retroviruses2019
Field Validation of Limiting-Antigen Avidity Enzyme Immunoassay to Estimate HIV-1 Incidence in Cross-Sectional Survey in Swaziland.
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 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Use of HIV Recency Assays for HIV Incidence Estimation and Other Surveillance Use Cases: Systematic Review.JMIR public health and surveillance · 2022Pooled it
- Evaluation of multi-assay algorithms for identifying individuals with recent HIV infection: HPTN 071 (PopART).PloS one · 2021Trial
- Self-reported Intimate Partner Violence Before and After Return of Recency Test Results: Findings from the Rwanda HIV Recency Evaluation Study.AIDS and behavior · 2026Article
- Analysis of HIV-1 recent infections and hotspot areas in a bordering area in Yunnan Province, China.BMC public health · 2025Article
- Field validation and application of the luminex triplex HIV assay to estimate HIV prevalence and HIV-1 incidence in Nigeria.PLOS global public health · 2025Article
- A Human Immunodeficiency Virus Type 1 Risk Assessment Tool for Women Aged 15-49 Years in African Countries: A Pooled Analysis Across 15 Nationally Representative Surveys.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Continuous quality evaluation of the Asanté rapid test for recent infection for robust kit lot quality verification.PLOS global public health · 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
- HIV Incidence, Recent HIV Infection, and Associated Factors, Kenya, 2007-2018.AIDS research and human retroviruses · 2023Article
- Recent HIV Infection: Diagnosis and Public Health Implications.Diagnostics (Basel, Switzerland) · 2022Review
- 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
- Validation of population-level HIV-1 incidence estimation by cross-sectional incidence assays in the HPTN 071 (PopART) trial.Journal of the International AIDS Society · 2021Article
- HIV Incidence by Male Circumcision Status From the Population-Based HIV Impact Assessment Surveys-Eight Sub-Saharan African Countries, 2015-2017.Journal of acquired immune deficiency syndromes (1999) · 2021Article
- A Comprehensive Approach to Assuring Quality of Laboratory Testing in HIV Surveys: Lessons Learned From the Population-Based HIV Impact Assessment Project.Journal of acquired immune deficiency syndromes (1999) · 2021Article
- Article
- A New Strategy to Quantitatively Identify Hot-Spot Areas in Growth of New HIV Infections for Targeted Interventions.Frontiers in public health · 2021Article
- Article
- HIV incidence, viremia, and the national response in Eswatini: Two sequential population-based surveys.PloS one · 2021Article
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
Reliable and accurate laboratory assays to detect recent HIV-1 infection have potential as simple and practical methods of estimating HIV-1 incidence in cross-sectional surveys. This study describes validation of the limiting-antigen (LAg) avidity enzyme immunoassay (EIA) in a cross-sectional national survey, conducted in Swaziland, comparing it to prospective follow-up incidence. As part of the Swaziland HIV-1 Incidence Measurement Survey (SHIMS), 18,172 individuals underwent counseling and HIV rapid testing in a household-based, population survey conducted from December 2010 to June 2011. Plasma samples from HIV-positive persons were classified as recent infections using an incidence testing algorithm with LAg-Avidity EIA (normalized optical density ≤1.5) followed by viral load (VL ≥1,000 copies/mL). All HIV-seronegative samples were tested for acute HIV-1 infection by nucleic acid amplification test (NAAT) pooling. HIV-seronegative individuals who consented to follow-up were retested ∼6 months later to detect observed HIV-1 seroconversion. HIV-1 incidence estimates based on LAg+VL and NAAT were calculated using assay-specific parameters and were compared with prospective incidence estimate. A total of 5,803 (31.9%) of 18,172 survey participants tested HIV seropositive; of these 5,683 (97.9%) were further tested with LAg+VL algorithm. The weighted annualized incidence from the longitudinal cohort study was 2.4% (95% confidence interval 2.0-2.7). Based on cross-sectional testing of HIV positives with LAg+VL algorithm, overall weighted annualized HIV-1 incidence was 2.5% (2.0-3.0), whereas NAAT-based incidence was of 2.6%. In addition, LAg-based incidence in men (1.8%; 1.2-2.5) and women (3.2%; 2.4-3.9) were similar to estimates based on observed incidence (men = 1.7%, women = 3.1%). Changes in HIV-1 incidence with age in men and women further validate plausibility of the algorithm. These results demonstrate that the LAg EIA, in a serial algorithm with VL, is a cost-effective tool to estimate HIV-1 incidence in cross-sectional surveys.
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