Recalibration of the Limiting Antigen Avidity EIA to Determine Mean Duration of Recent Infection in Divergent HIV-1 Subtypes

作者：Yen T. Duong, Reshma Kassanjee, Alex Welte, Meade Morgan, Anindya K. De, Trudy Dobbs, Erin Rottinghaus, John N. Nkengasong, Marcel E. Curlin, Chonticha Kittinunvorakoon, Boonyos Raengsakulrach, Michael Martin, Kachit Choopanya, Suphak Vanichseni, Yan Jiang, Maofeng Qiu, Haiying Yu, Yan Hao, Neha Shah, Linh‐Vi Le, Andrea A. Kim, Tuan Anh Nguyen, William Ampofo, Bharat Parekh · 发表于：PLoS ONE · 年份：2015 · DOI：10.1371/journal.pone.0114947 · 被引用次数：97 · 研究领域：HIV Research and Treatment、HIV/AIDS Research and Interventions、HIV/AIDS drug development and treatment

BACKGROUND: Mean duration of recent infection (MDRI) and misclassification of long-term HIV-1 infections, as proportion false recent (PFR), are critical parameters for laboratory-based assays for estimating HIV-1 incidence. Recent review of the data by us and others indicated that MDRI of LAg-Avidity EIA estimated previously required recalibration. We present here results of recalibration efforts using >250 seroconversion panels and multiple statistical methods to ensure accuracy and consensus. METHODS: A total of 2737 longitudinal specimens collected from 259 seroconverting individuals infected with diverse HIV-1 subtypes were tested with the LAg-Avidity EIA as previously described. Data were analyzed for determination of MDRI at ODn cutoffs of 1.0 to 2.0 using 7 statistical approaches and sub-analyzed by HIV-1 subtypes. In addition, 3740 specimens from individuals with infection >1 year, including 488 from patients with AIDS, were tested for PFR at varying cutoffs. RESULTS: Using different statistical methods, MDRI values ranged from 88-94 days at cutoff ODn = 1.0 to 177-183 days at ODn = 2.0. The MDRI values were similar by different methods suggesting coherence of different approaches. Testing for misclassification among long-term infections indicated that overall PFRs were 0.6% to 2.5% at increasing cutoffs of 1.0 to 2.0, respectively. Balancing the need for a longer MDRI and smaller PFR (<2.0%) suggests that a cutoff ODn = 1.5, corresponding to an MDRI of 130 days shoul...