TY - JOUR
T1 - Use of a multifaceted approach to analyze HIV incidence in a cohort study of women in the United States
T2 - HIV prevention trials network 064 study
AU - Eshleman, Susan H.
AU - Hughes, James P.
AU - Laeyendecker, Oliver
AU - Wang, Jing
AU - Brookmeyer, Ron
AU - Johnson-Lewis, Letanya
AU - Mullis, Caroline E.
AU - Hackett, John
AU - Vallari, Ana S.
AU - Justman, Jessica
AU - Hodder, Sally
N1 - Funding Information:
Financial support. This work was supported by the HPTN, sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute on Drug Abuse, the National Institute of Mental Health, and the Office of AIDS Research, NIH, Department of Health and Human Services (DHHS) (grants U01AI068613/UM1AI068613 [to the HPTN Network Laboratory; S. H. E., principal investigator], U01AI068617 [to the HPTN Statistical and Data Management Center; Deborah Donnell, principal investigator], and U01AI068619 [to the HPTN Core and Operations Center; Sten Vermund, principal investigator]); the Division of Intramural Research, NIAID, NIH, DHHS; and the NIAID, NIH, DHHS (grant R01-AI095068 to S. H. E, principal investigator).
PY - 2013
Y1 - 2013
N2 - Background. Reliable methods for estimating the incidence of human immunodeficiency virus (HIV) infection are needed to monitor the epidemic, identify at-risk populations, and evaluate HIV prevention strategies. We used a multifaceted approach to estimate HIV incidence in the HIV Prevention Trials Network (HPTN) 064 study.Methods. The HPTN 064 study enrolled 2067 HIV-seronegative women and 32 HIV-seropositive women with no prior HIV infection diagnosis. Women were followed for up to 12 months. HIV incidence estimates were based on (1) detection of acute HIV infection, (2) documentation of HIV seroconversion, and (3) detection of recent HIV infection, using a multiassay algorithm (MAA).Results. Two women had acute HIV infection at enrollment, 4 seroconverted, and 2 were identified as recently infected at enrollment using the MAA. The annual HIV incidence estimate based on acute infection at enrollment (2.52% [95% confidence interval {CI},. 17%-9.33%], using a 14-day window period) was higher than the estimate based on seroconversion (0.24% [95% CI,. 07%-.62%]; P =. 027). Incidence estimates obtained using the MAA at enrollment and at the end of study were 0.25% (95% CI,. 03%-.93%) and 0.13% (95% CI,. 006%-.76%), respectively.Conclusions. We detected a high frequency of acute infection at enrollment. Cross-sectional HIV incidence estimates obtained using the MAA were similar to the longitudinal estimate based on HIV seroconversion.
AB - Background. Reliable methods for estimating the incidence of human immunodeficiency virus (HIV) infection are needed to monitor the epidemic, identify at-risk populations, and evaluate HIV prevention strategies. We used a multifaceted approach to estimate HIV incidence in the HIV Prevention Trials Network (HPTN) 064 study.Methods. The HPTN 064 study enrolled 2067 HIV-seronegative women and 32 HIV-seropositive women with no prior HIV infection diagnosis. Women were followed for up to 12 months. HIV incidence estimates were based on (1) detection of acute HIV infection, (2) documentation of HIV seroconversion, and (3) detection of recent HIV infection, using a multiassay algorithm (MAA).Results. Two women had acute HIV infection at enrollment, 4 seroconverted, and 2 were identified as recently infected at enrollment using the MAA. The annual HIV incidence estimate based on acute infection at enrollment (2.52% [95% confidence interval {CI},. 17%-9.33%], using a 14-day window period) was higher than the estimate based on seroconversion (0.24% [95% CI,. 07%-.62%]; P =. 027). Incidence estimates obtained using the MAA at enrollment and at the end of study were 0.25% (95% CI,. 03%-.93%) and 0.13% (95% CI,. 006%-.76%), respectively.Conclusions. We detected a high frequency of acute infection at enrollment. Cross-sectional HIV incidence estimates obtained using the MAA were similar to the longitudinal estimate based on HIV seroconversion.
KW - HIV-1
KW - United States
KW - incidence
KW - women
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U2 - 10.1093/infdis/jis658
DO - 10.1093/infdis/jis658
M3 - Article
C2 - 23129758
AN - SCOPUS:84871747615
VL - 207
SP - 223
EP - 231
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
SN - 0022-1899
IS - 2
ER -