Screening acute HIV infections among Chinese men who have sex with men from voluntary counseling & testing centers.
BACKGROUND: Recent studies have shown the public health importance of identifying acute HIV infection (AHI) in the men who have sex with men (MSM) of China, which has a much higher risk of HIV transmission. However, cost-utility analyses to guide policy around AHI screening are lacking. METHODOLOGY/...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2011-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3237549?pdf=render |
| _version_ | 1818316081698177024 |
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| author | Xiaoxu Han Junjie Xu Zhenxing Chu Di Dai Chunming Lu Xu Wang Li Zhao Cheng Zhang Yangtao Ji Hui Zhang Hong Shang |
| author_facet | Xiaoxu Han Junjie Xu Zhenxing Chu Di Dai Chunming Lu Xu Wang Li Zhao Cheng Zhang Yangtao Ji Hui Zhang Hong Shang |
| author_sort | Xiaoxu Han |
| collection | DOAJ |
| description | BACKGROUND: Recent studies have shown the public health importance of identifying acute HIV infection (AHI) in the men who have sex with men (MSM) of China, which has a much higher risk of HIV transmission. However, cost-utility analyses to guide policy around AHI screening are lacking. METHODOLOGY/PRINCIPAL FINDINGS: An open prospective cohort was recruited among MSM living in Liaoning Province, Northeast China. Blood samples and epidemiological information were collected every 10 weeks. Third-generation ELISA and rapid test were used for HIV antibody screening, western blot assay (WB) served for assay validation. Antibody negative specimens were tested with 24 mini-pool nucleic acid amplification testing (NAAT). Specimens with positive ELISA but negative or indeterminate WB results were tested with NAAT individually without mixing. A cost-utility analysis of NAAT screening was assessed. Among the 5,344 follow-up visits of 1,765 MSM in 22 months, HIV antibody tests detected 114 HIV chronic infections, 24 seroconverters and 21 antibody indeterminate cases. 29 acute HIV infections were detected with NAAT from 21 antibody indeterminate and 1,606 antibody negative cases. The HIV-1 prevalence and incidence density were 6.6% (95% CI: 5.5-7.9) and 7.1 (95% CI: 5.4-9.2)/100 person-years, respectively. With pooled NAAT and individual NAAT strategy, the cost of an HIV transmission averted was $1,480. The addition of NAAT after HIV antibody tests had a cost-utility ratio of $3,366 per gained quality-adjusted life year (QALY). The input-output ratio of NAAT was about 1∶16.9. CONCLUSIONS/SIGNIFICANCE: The HIV infections among MSM continue to rise at alarming rates. Despite the rising cost, adding pooled NAAT to the HIV antibody screening significantly increases the identification of acute HIV infections in MSM. Early treatment and target-oriented publicity and education programs can be strengthened to decrease the risk of HIV transmission and to save medical resources in the long run. |
| first_indexed | 2024-12-13T09:15:46Z |
| format | Article |
| id | doaj.art-3ee38dabc7cf4068b1bbfa3099ef11cf |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T09:15:46Z |
| publishDate | 2011-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-3ee38dabc7cf4068b1bbfa3099ef11cf2022-12-21T23:52:50ZengPublic Library of Science (PLoS)PLoS ONE1932-62032011-01-01612e2879210.1371/journal.pone.0028792Screening acute HIV infections among Chinese men who have sex with men from voluntary counseling & testing centers.Xiaoxu HanJunjie XuZhenxing ChuDi DaiChunming LuXu WangLi ZhaoCheng ZhangYangtao JiHui ZhangHong ShangBACKGROUND: Recent studies have shown the public health importance of identifying acute HIV infection (AHI) in the men who have sex with men (MSM) of China, which has a much higher risk of HIV transmission. However, cost-utility analyses to guide policy around AHI screening are lacking. METHODOLOGY/PRINCIPAL FINDINGS: An open prospective cohort was recruited among MSM living in Liaoning Province, Northeast China. Blood samples and epidemiological information were collected every 10 weeks. Third-generation ELISA and rapid test were used for HIV antibody screening, western blot assay (WB) served for assay validation. Antibody negative specimens were tested with 24 mini-pool nucleic acid amplification testing (NAAT). Specimens with positive ELISA but negative or indeterminate WB results were tested with NAAT individually without mixing. A cost-utility analysis of NAAT screening was assessed. Among the 5,344 follow-up visits of 1,765 MSM in 22 months, HIV antibody tests detected 114 HIV chronic infections, 24 seroconverters and 21 antibody indeterminate cases. 29 acute HIV infections were detected with NAAT from 21 antibody indeterminate and 1,606 antibody negative cases. The HIV-1 prevalence and incidence density were 6.6% (95% CI: 5.5-7.9) and 7.1 (95% CI: 5.4-9.2)/100 person-years, respectively. With pooled NAAT and individual NAAT strategy, the cost of an HIV transmission averted was $1,480. The addition of NAAT after HIV antibody tests had a cost-utility ratio of $3,366 per gained quality-adjusted life year (QALY). The input-output ratio of NAAT was about 1∶16.9. CONCLUSIONS/SIGNIFICANCE: The HIV infections among MSM continue to rise at alarming rates. Despite the rising cost, adding pooled NAAT to the HIV antibody screening significantly increases the identification of acute HIV infections in MSM. Early treatment and target-oriented publicity and education programs can be strengthened to decrease the risk of HIV transmission and to save medical resources in the long run.http://europepmc.org/articles/PMC3237549?pdf=render |
| spellingShingle | Xiaoxu Han Junjie Xu Zhenxing Chu Di Dai Chunming Lu Xu Wang Li Zhao Cheng Zhang Yangtao Ji Hui Zhang Hong Shang Screening acute HIV infections among Chinese men who have sex with men from voluntary counseling & testing centers. PLoS ONE |
| title | Screening acute HIV infections among Chinese men who have sex with men from voluntary counseling & testing centers. |
| title_full | Screening acute HIV infections among Chinese men who have sex with men from voluntary counseling & testing centers. |
| title_fullStr | Screening acute HIV infections among Chinese men who have sex with men from voluntary counseling & testing centers. |
| title_full_unstemmed | Screening acute HIV infections among Chinese men who have sex with men from voluntary counseling & testing centers. |
| title_short | Screening acute HIV infections among Chinese men who have sex with men from voluntary counseling & testing centers. |
| title_sort | screening acute hiv infections among chinese men who have sex with men from voluntary counseling testing centers |
| url | http://europepmc.org/articles/PMC3237549?pdf=render |
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