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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/2234

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
Publisher: AAU
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 validated, however. 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.
URI: http://hdl.handle.net/123456789/2234
Appears in:Thesis - Medical Microbiology

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