Development of a multiassay algorithm (MAA) to identify recent HIV infection in newly diagnosed individuals in Indonesia

Summary: Ongoing HIV transmission is a public health priority in Indonesia. We developed a new multiassay algorithm (MAA) to identify recent HIV infection. The MAA is a sequential decision tree based on multiple biomarkers, starting with CD4+ T cells >200/μL, followed by plasma viral load (pVL) &...

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Main Authors: Wahyu Nawang Wulan, Evy Yunihastuti, Dona Arlinda, Tuti Parwati Merati, Rudi Wisaksana, Dewi Lokida, Zehava Grossman, Kristi Huik, Chuen-Yen Lau, Nugroho Harry Susanto, Herman Kosasih, Abu Tholib Aman, Sunarto Ang, Rita Evalina, Anak Agung Ayu Yuli Gayatri, Chakrawati Hayuningsih, Agnes Rengga Indrati, July Kumalawati, Vivi Keumala Mutiawati, Mario Bernardinus Realino Nara, Asvin Nurulita, Rahmawati Rahmawati, Adria Rusli, Musofa Rusli, Dewi Yennita Sari, Justina Sembiring, Muchlis Achsan Udji Sofro, Wiwi Endang Susanti, Janice Tandraeliene, Fransisca Lianiwati Tanzil, Aaron Neal, Muhammad Karyana, Pratiwi Sudarmono, Frank Maldarelli
Format: Article
Language:English
Published: Elsevier 2023-10-01
Series:iScience
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589004223020631
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Summary:Summary: Ongoing HIV transmission is a public health priority in Indonesia. We developed a new multiassay algorithm (MAA) to identify recent HIV infection. The MAA is a sequential decision tree based on multiple biomarkers, starting with CD4+ T cells >200/μL, followed by plasma viral load (pVL) > 1,000 copies/ml, avidity index (AI) < 0 · 7, and pol ambiguity <0 · 47%. Plasma from 140 HIV-infected adults from 19 hospitals across Indonesia (January 2018 – June 2020) was studied, consisting of a training set (N = 60) of longstanding infection (>12-month) and a test set (N = 80) of newly diagnosed (≤1-month) antiretroviral (ARV) drug naive individuals. Ten of eighty (12 · 5%) newly diagnosed individuals were classified as recent infections. Drug resistance mutations (DRMs) against reverse transcriptase inhibitors were identified in two individuals: one infected with HIV subtype C (K219Q, V179T) and the other with CRF01_AE (V179D). Ongoing HIV transmission, including infections with DRMs, is substantial in Indonesia.
ISSN:2589-0042