Journal
AIDS RESEARCH AND HUMAN RETROVIRUSES
Volume 28, Issue 8, Pages 816-822Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/aid.2011.0258
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Funding
- IV Prevention Trials Network (HPTN)
- National Institute of Allergy and Infectious Diseases (NIAID), National Institute on Drug Abuse, National Institute of Mental Health
- Office of AIDS Research, of the NIH, DHHS [U01-AI46745, U01-AI48054, U01-AI068613, UM1-AI068613]
- International Maternal Pediatric and Adolescent AIDS Clinical Trials (IMPAACT) Network [U01-AI068632]
- Multicenter AIDS Cohort Study (MACS)
- NIAID
- National Cancer Institute
- National Heart, Lung and Blood Institute [UO1-AI35042, UL1-RR025005, UO1-AI35043, UO1-AI35039, UO1-AI35040, UO1-AI35041]
- Division of Intramural Research, NIAID, NIH
- [1R01-AI095068]
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The BED capture enzyme immunoassay (BED-CEIA) was developed for estimating HIV incidence from cross-sectional data. This assay misclassifies some individuals with nonrecent HIV infection as recently infected, leading to overestimation of HIV incidence. We analyzed factors associated with misclassification by the BED-CEIA. We analyzed samples from 383 men who were diagnosed with HIV infection less than 1 year after a negative HIV test (Multicenter AIDS Cohort Study). Samples were collected 2-8 years after HIV seroconversion, which was defined as the midpoint between the last negative and first positive HIV test. Samples were analyzed using the BED-CEIA with a cutoff of OD-n <= 0.8 for recent infection. Logistic regression was used to identify factors associated with misclassification. Ninety-one (15.1%) of 603 samples were misclassified. In multivariate models, misclassification was independently associated with highly active antiretroviral treatment (HAART) for >2 years, HIV RNA <400 copies/ml, and CD4 cell count <50 or <200 cells/mm(3); adjusted odds ratios (OR) and 95% confidence intervals (CI) were 4.72 (1.35-16.5), 3.96 (1.53-10.3), 6.85 (2.71-17.4), and 11.5 (3.64-36.0), respectively. Among 220 men with paired samples, misclassification 2-4 years after seroconversion was significantly associated with misclassification 6-8 years after seroconversion [adjusted OR: 25.8 (95% CI: 8.17-81.5), p < 0.001] after adjusting for race, CD4 cell count, HIV viral load, and HAART use. Low HIV viral load, low CD4 cell count, and >2 years of HAART were significantly associated with misclassification using the BED-CEIA. Some men were persistently misclassified as recently infected up to 8 years after HIV seroconversion.
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