Do tests devised to detect recent HIV-1 infection provide reliable estimates of incidence in Africa?

Charlotte Sakarovitch (1, 2) , Francois Rouet (3) , Gary Murphy (4) , Albert K. Minga (5) , Ahmadou Alioum (1) , Francois Dabis (2) , Dominique Costagliola (6) , Roger Salamon (2) , John V. Parry (4) , Francis Barin (7)

1 Equipe de Biostatistique
2 Epidémiologie, santé publique et développement
3 CeDreS - Centre de recherche et de Diagnostic sur le Sida [Abidjan, Côte d'Ivoire]
4 Virus Reference Department
5 ANRS 1220 - PRIMO-CI, Programme PAC-CI
6 Epidémiologie Clinique et Traitement de l'Infection à VIH
7 Virus, pseudo-virus: Morphogénèse et Antigénicité

The objective of this study was to assess the performance of 4 biologic tests designed to detect recent HIV-1 infections in estimating incidence in West Africa (BED, Vironostika, Avidity, and IDE-V3). These tests were assessed on a panel of 135 samples from 79 HIV-1-positive regular blood donors from Abidjan, C?d'Ivoire, whose date of seroconversion was known (Agence Nationale de Recherches sur le SIDA et les H?tites Virales 1220 cohort). The 135 samples included 26 from recently infected patients (< or =180 days), 94 from AIDS-free subjects with long-standing infection (>180 days), and 15 from patients with clinical AIDS. The performance of each assay in estimating HIV incidence was assessed through simulations. The modified commercial assays gave the best results for sensitivity (100% for both), and the IDE-V3 technique gave the best result for specificity (96.3%). In a context like Abidjan, with a 10% HIV-1 prevalence associated with a 1% annual incidence, the estimated test-specific annual incidence rates would be 1.2% (IDE-V3), 5.5% (Vironostika), 6.2% (BED), and 11.2% (Avidity). Most of the specimens falsely classified as incident cases were from patients infected for >180 days but <1 year. The authors conclude that none of the 4 methods could currently be used to estimate HIV-1 incidence routinely in C?d'Ivoire but that further adaptations might enhance their accuracy.

Domaines: Santé publique et épidémiologie

Charlotte Sakarovitch, Francois Rouet, Gary Murphy, Albert K. Minga, Ahmadou Alioum, et al.. Do tests devised to detect recent HIV-1 infection provide reliable estimates of incidence in Africa?. Journal of Acquired Immune Deficiency Syndromes - JAIDS, 2007, 45 (1), pp.115-22. ⟨10.1097/QAI.0b013e318050d277⟩. ⟨inserm-00175885⟩