Simple estimation of incident HIV infection rates in notification cohorts based on window periods of algorithms for evaluation of line-immunoassay result patterns.

Tests for recent infections (TRIs) are important for HIV surveillance. We have shown that a patient's antibody pattern in a confirmatory line immunoassay (Inno-Lia) also yields information on time since infection. We have published algorithms which, with a certain sensitivity and specificity, d...

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Main Authors: Jörg Schüpbach, Martin D Gebhardt, Alexandra U Scherrer, Leslie R Bisset, Christoph Niederhauser, Stephan Regenass, Sabine Yerly, Vincent Aubert, Franziska Suter, Stefan Pfister, Gladys Martinetti, Corinne Andreutti, Thomas Klimkait, Marcel Brandenberger, Huldrych F Günthard, Swiss HIV Cohort Study
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3753319?pdf=render
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author Jörg Schüpbach
Martin D Gebhardt
Alexandra U Scherrer
Leslie R Bisset
Christoph Niederhauser
Stephan Regenass
Sabine Yerly
Vincent Aubert
Franziska Suter
Stefan Pfister
Gladys Martinetti
Corinne Andreutti
Thomas Klimkait
Marcel Brandenberger
Huldrych F Günthard
Swiss HIV Cohort Study
author_facet Jörg Schüpbach
Martin D Gebhardt
Alexandra U Scherrer
Leslie R Bisset
Christoph Niederhauser
Stephan Regenass
Sabine Yerly
Vincent Aubert
Franziska Suter
Stefan Pfister
Gladys Martinetti
Corinne Andreutti
Thomas Klimkait
Marcel Brandenberger
Huldrych F Günthard
Swiss HIV Cohort Study
author_sort Jörg Schüpbach
collection DOAJ
description Tests for recent infections (TRIs) are important for HIV surveillance. We have shown that a patient's antibody pattern in a confirmatory line immunoassay (Inno-Lia) also yields information on time since infection. We have published algorithms which, with a certain sensitivity and specificity, distinguish between incident (< = 12 months) and older infection. In order to use these algorithms like other TRIs, i.e., based on their windows, we now determined their window periods.We classified Inno-Lia results of 527 treatment-naïve patients with HIV-1 infection < = 12 months according to incidence by 25 algorithms. The time after which all infections were ruled older, i.e. the algorithm's window, was determined by linear regression of the proportion ruled incident in dependence of time since infection. Window-based incident infection rates (IIR) were determined utilizing the relationship 'Prevalence = Incidence x Duration' in four annual cohorts of HIV-1 notifications. Results were compared to performance-based IIR also derived from Inno-Lia results, but utilizing the relationship 'incident = true incident + false incident' and also to the IIR derived from the BED incidence assay.Window periods varied between 45.8 and 130.1 days and correlated well with the algorithms' diagnostic sensitivity (R(2) = 0.962; P<0.0001). Among the 25 algorithms, the mean window-based IIR among the 748 notifications of 2005/06 was 0.457 compared to 0.453 obtained for performance-based IIR with a model not correcting for selection bias. Evaluation of BED results using a window of 153 days yielded an IIR of 0.669. Window-based IIR and performance-based IIR increased by 22.4% and respectively 30.6% in 2008, while 2009 and 2010 showed a return to baseline for both methods.IIR estimations by window- and performance-based evaluations of Inno-Lia algorithm results were similar and can be used together to assess IIR changes between annual HIV notification cohorts.
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spelling doaj.art-7c01cb9ceda04fedac9c41aaf214ae942022-12-22T01:52:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0188e7166210.1371/journal.pone.0071662Simple estimation of incident HIV infection rates in notification cohorts based on window periods of algorithms for evaluation of line-immunoassay result patterns.Jörg SchüpbachMartin D GebhardtAlexandra U ScherrerLeslie R BissetChristoph NiederhauserStephan RegenassSabine YerlyVincent AubertFranziska SuterStefan PfisterGladys MartinettiCorinne AndreuttiThomas KlimkaitMarcel BrandenbergerHuldrych F GünthardSwiss HIV Cohort StudyTests for recent infections (TRIs) are important for HIV surveillance. We have shown that a patient's antibody pattern in a confirmatory line immunoassay (Inno-Lia) also yields information on time since infection. We have published algorithms which, with a certain sensitivity and specificity, distinguish between incident (< = 12 months) and older infection. In order to use these algorithms like other TRIs, i.e., based on their windows, we now determined their window periods.We classified Inno-Lia results of 527 treatment-naïve patients with HIV-1 infection < = 12 months according to incidence by 25 algorithms. The time after which all infections were ruled older, i.e. the algorithm's window, was determined by linear regression of the proportion ruled incident in dependence of time since infection. Window-based incident infection rates (IIR) were determined utilizing the relationship 'Prevalence = Incidence x Duration' in four annual cohorts of HIV-1 notifications. Results were compared to performance-based IIR also derived from Inno-Lia results, but utilizing the relationship 'incident = true incident + false incident' and also to the IIR derived from the BED incidence assay.Window periods varied between 45.8 and 130.1 days and correlated well with the algorithms' diagnostic sensitivity (R(2) = 0.962; P<0.0001). Among the 25 algorithms, the mean window-based IIR among the 748 notifications of 2005/06 was 0.457 compared to 0.453 obtained for performance-based IIR with a model not correcting for selection bias. Evaluation of BED results using a window of 153 days yielded an IIR of 0.669. Window-based IIR and performance-based IIR increased by 22.4% and respectively 30.6% in 2008, while 2009 and 2010 showed a return to baseline for both methods.IIR estimations by window- and performance-based evaluations of Inno-Lia algorithm results were similar and can be used together to assess IIR changes between annual HIV notification cohorts.http://europepmc.org/articles/PMC3753319?pdf=render
spellingShingle Jörg Schüpbach
Martin D Gebhardt
Alexandra U Scherrer
Leslie R Bisset
Christoph Niederhauser
Stephan Regenass
Sabine Yerly
Vincent Aubert
Franziska Suter
Stefan Pfister
Gladys Martinetti
Corinne Andreutti
Thomas Klimkait
Marcel Brandenberger
Huldrych F Günthard
Swiss HIV Cohort Study
Simple estimation of incident HIV infection rates in notification cohorts based on window periods of algorithms for evaluation of line-immunoassay result patterns.
PLoS ONE
title Simple estimation of incident HIV infection rates in notification cohorts based on window periods of algorithms for evaluation of line-immunoassay result patterns.
title_full Simple estimation of incident HIV infection rates in notification cohorts based on window periods of algorithms for evaluation of line-immunoassay result patterns.
title_fullStr Simple estimation of incident HIV infection rates in notification cohorts based on window periods of algorithms for evaluation of line-immunoassay result patterns.
title_full_unstemmed Simple estimation of incident HIV infection rates in notification cohorts based on window periods of algorithms for evaluation of line-immunoassay result patterns.
title_short Simple estimation of incident HIV infection rates in notification cohorts based on window periods of algorithms for evaluation of line-immunoassay result patterns.
title_sort simple estimation of incident hiv infection rates in notification cohorts based on window periods of algorithms for evaluation of line immunoassay result patterns
url http://europepmc.org/articles/PMC3753319?pdf=render
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