Integration of a recent infection testing algorithm into HIV surveillance in Ireland: improving HIV knowledge to target prevention.
Epidemiol Infect
; 147: e136, 2019 01.
Article
em En
| MEDLINE
| ID: mdl-30869051
ABSTRACT
Recent infection testing algorithms (RITA) for HIV combine serological assays with epidemiological data to determine likely recent infections, indicators of ongoing transmission. In 2016, we integrated RITA into national HIV surveillance in Ireland to better inform HIV prevention interventions. We determined the avidity index (AI) of new HIV diagnoses and linked the results with data captured in the national infectious disease reporting system. RITA classified a diagnosis as recent based on an AI < 1.5, unless epidemiological criteria (CD4 count <200 cells/mm3; viral load <400 copies/ml; the presence of AIDS-defining illness; prior antiretroviral therapy use) indicated a potential false-recent result. Of 508 diagnoses in 2016, we linked 448 (88.1%) to an avidity test result. RITA classified 12.5% of diagnoses as recent, with the highest proportion (26.3%) amongst people who inject drugs. On multivariable logistic regression recent infection was more likely with a concurrent sexually transmitted infection (aOR 2.59; 95% CI 1.04-6.45). Data were incomplete for at least one RITA criterion in 48% of cases. The study demonstrated the feasibility of integrating RITA into routine surveillance and showed some ongoing HIV transmission. To improve the interpretation of RITA, further efforts are required to improve completeness of the required epidemiological data.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Algoritmos
/
Testes Sorológicos
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Infecções por HIV
/
Monitoramento Epidemiológico
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
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Screening_studies
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Epidemiol Infect
Assunto da revista:
DOENCAS TRANSMISSIVEIS
/
EPIDEMIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Irlanda