HIV Incidence in Rural South Africa: Comparison of Estimates from Longitudinal Surveillance and Cross-Sectional cBED Assay Testing
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{"title"=>"HIV incidence in rural South Africa: Comparison of estimates from longitudinal surveillance and cross-sectional cBED assay testing", "type"=>"journal", "authors"=>[{"first_name"=>"Till", "last_name"=>"Bärnighausen", "scopus_author_id"=>"23011726900"}, {"first_name"=>"Claudia", "last_name"=>"Wallrauch", "scopus_author_id"=>"6602349288"}, {"first_name"=>"Alex", "last_name"=>"Welte", "scopus_author_id"=>"25028861200"}, {"first_name"=>"Thomas A.", "last_name"=>"McWalter", "scopus_author_id"=>"35484777800"}, {"first_name"=>"Nhlanhla", "last_name"=>"Mbizana", "scopus_author_id"=>"25646178800"}, {"first_name"=>"Johannes", "last_name"=>"Viljoen", "scopus_author_id"=>"25223916600"}, {"first_name"=>"Natalie", "last_name"=>"Graham", "scopus_author_id"=>"25645584300"}, {"first_name"=>"Frank", "last_name"=>"Tanser", "scopus_author_id"=>"6603089893"}, {"first_name"=>"Adrian", "last_name"=>"Puren", "scopus_author_id"=>"6603367058"}, {"first_name"=>"Marie Louise", "last_name"=>"Newell", "scopus_author_id"=>"7102860013"}], "year"=>2008, "source"=>"PLoS ONE", "identifiers"=>{"isbn"=>"1932-6203", "pmid"=>"18982059", "doi"=>"10.1371/journal.pone.0003640", "pui"=>"352678728", "issn"=>"19326203", "sgr"=>"56149112558", "scopus"=>"2-s2.0-56149112558"}, "id"=>"d0a5a67e-ecf4-30e1-9545-96e35f6a05c4", "abstract"=>"BACKGROUND: The BED IgG-Capture Enzyme Immunoassay (cBED assay), a test of recent HIV infection, has been used to estimate HIV incidence in cross-sectional HIV surveys. However, there has been concern that the assay overestimates HIV incidence to an unknown extent because it falsely classifies some individuals with non-recent HIV infections as recently infected. We used data from a longitudinal HIV surveillance in rural South Africa to measure the fraction of people with non-recent HIV infection who are falsely classified as recently HIV-infected by the cBED assay (the long-term false-positive ratio (FPR)) and compared cBED assay-based HIV incidence estimates to longitudinally measured HIV incidence. METHODOLOGY/PRINCIPAL FINDINGS: We measured the long-term FPR in individuals with two positive HIV tests (in the HIV surveillance, 2003-2006) more than 306 days apart (sample size n = 1,065). We implemented four different formulae to calculate HIV incidence using cBED assay testing (n = 11,755) and obtained confidence intervals (CIs) by directly calculating the central 95(th) percentile of incidence values. We observed 4,869 individuals over 7,685 person-years for longitudinal HIV incidence estimation. The long-term FPR was 0.0169 (95% CI 0.0100-0.0266). Using this FPR, the cross-sectional cBED-based HIV incidence estimates (per 100 people per year) varied between 3.03 (95% CI 2.44-3.63) and 3.19 (95% CI 2.57-3.82), depending on the incidence formula. Using a long-term FPR of 0.0560 based on previous studies, HIV incidence estimates varied between 0.65 (95% CI 0.00-1.32) and 0.71 (95% CI 0.00-1.43). The longitudinally measured HIV incidence was 3.09 per 100 people per year (95% CI 2.69-3.52), after adjustment to the sex-age distribution of the sample used in cBED assay-based estimation. CONCLUSIONS/SIGNIFICANCE: In a rural community in South Africa with high HIV prevalence, the long-term FPR of the cBED assay is substantially lower than previous estimates. The cBED assay performs well in HIV incidence estimation if the locally measured long-term FPR is used, but significantly underestimates incidence when a FPR estimate based on previous studies in other settings is used.", "link"=>"http://www.mendeley.com/research/hiv-incidence-rural-south-africa-comparison-estimates-longitudinal-surveillance-crosssectional-cbed", "reader_count"=>63, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>1, "Librarian"=>1, "Student > Doctoral Student"=>4, "Researcher"=>23, "Student > Ph. D. Student"=>11, "Student > Postgraduate"=>2, "Other"=>2, "Student > Master"=>11, "Student > Bachelor"=>1, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>5}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>1, "Librarian"=>1, "Student > Doctoral Student"=>4, "Researcher"=>23, "Student > Ph. D. Student"=>11, "Student > Postgraduate"=>2, "Other"=>2, "Student > Master"=>11, "Student > Bachelor"=>1, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>5}, "reader_count_by_subject_area"=>{"Unspecified"=>6, "Environmental Science"=>1, "Nursing and Health Professions"=>2, "Mathematics"=>6, "Medicine and Dentistry"=>33, "Agricultural and Biological Sciences"=>3, "Business, Management and Accounting"=>2, "Social Sciences"=>9, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>33}, "Social Sciences"=>{"Social Sciences"=>9}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>2}, "Mathematics"=>{"Mathematics"=>6}, "Unspecified"=>{"Unspecified"=>6}, "Environmental Science"=>{"Environmental Science"=>1}}, "reader_count_by_country"=>{"United States"=>1, "Tanzania"=>1}, "group_count"=>5}

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Figshare

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  • {"files"=>["https://ndownloader.figshare.com/files/916927"], "description"=>"<p>CI = confidence interval, FPR = false-positive ratio.</p>", "links"=>[], "tags"=>["incidence"], "article_id"=>587379, "categories"=>["Computational Biology", "Cancer", "Neuroscience"], "users"=>["Till Bärnighausen", "Claudia Wallrauch", "Alex Welte", "Thomas A. McWalter", "Nhlanhla Mbizana", "Johannes Viljoen", "Natalie Graham", "Frank Tanser", "Adrian Puren", "Marie-Louise Newell"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0003640.t002", "stats"=>{"downloads"=>1, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_HIV_incidence_estimates_/587379", "title"=>"HIV incidence estimates.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-21 07:41:56"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"5", "full-text"=>"5", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"1"}
  • {"unique-ip"=>"1", "full-text"=>"1", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"2"}
  • {"unique-ip"=>"10", "full-text"=>"11", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
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  • {"unique-ip"=>"4", "full-text"=>"4", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
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  • {"unique-ip"=>"5", "full-text"=>"4", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"12"}
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  • {"unique-ip"=>"10", "full-text"=>"10", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"3"}
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  • {"unique-ip"=>"3", "full-text"=>"3", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"7"}
  • {"unique-ip"=>"2", "full-text"=>"0", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"8"}
  • {"unique-ip"=>"4", "full-text"=>"6", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"9"}
  • {"unique-ip"=>"9", "full-text"=>"6", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"10"}
  • {"unique-ip"=>"1", "full-text"=>"0", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"11"}
  • {"unique-ip"=>"2", "full-text"=>"1", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"12"}
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Relative Metric

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