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|Title: ||COMPARISON OF THE BED HIV-1 INCIDENCE ASSAY WITH THE WHO CRITERIA FOR IDENTIFYING RECENTLY HIV-INFECTED INDIVIDUALS|
|Authors: ||JEMAL, ALI|
|Advisors: ||YOHANNES MENGISTU (B. Sc., M. Sc., Ph D., MPH)|
DAWIT WOLDAY (MD., M. Sc., Ph D.)
|Keywords: ||medical microbiology|
|Copyright: ||Jul-2009 |
|Date Added: ||3-May-2012 |
|Abstract: ||Background: With the advent of antiretroviral therapy (ART) in several developing
countries, WHO has proposed that countries should monitor HIV drug resistance
(HIVDR) based on a population-based threshold survey. The guideline uses age-criteria
to identify newly infected individuals. The accuracy of such guideline has not been
Objective: To compare the WHO criteria for identifying recently infected individuals
with a biological marker HIV-1 BED incidence assay.
Methods: Individuals were enrolled from OSSA VCT center. Initial HIV screening was
done based on current national Rapid HIV screening algorithm. Based on the WHO
criteria, those who were identified as HIV-positive were classified as recently infected if
< 25years of age. Moreover the HIV-positive specimens were subjected to HIV-1 BED
incidence assay. Finally the two results were compared.
Results: A total of 4492 individuals underwent VCT and screened for HIV. Of these 360
(8.0 %) were found to be HIV-positive; 64 (17.8 %) were identified as recently infected
based on the WHO criteria. Moreover, of those 360 HIV-positive individuals 42 (11.7 %)
were identified as recently infected by the HIV-1 BED incidence assay; giving an
estimated incidence of 2.36 % per year [95% CI, 1.7-3.1]. However, only 13 (3.6 %)
HIV-infected individuals were identified by the WHO criteria and BED incidence assay.
Conclusion: The concordance between WHO criteria and BED assay was only 3.6%.
This is very low agreement, which is below the expected. Plausible reasons might be
overestimation using WHO criteria (more crude way of selection as 25 yrs as cut-off is
higher), underestimation using BED assay, or the vice versa in which irrespective
estimation of the two criteria. In the absence of current gold-standard to decide which of
the above criteria is more accurate, the need for identifying recent HIV infection for the
purpose of population based studies is urgent.|
|Appears in:||Thesis - Medical Microbiology|
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