Infection Staging and Incidence Surveillance Applications of High Dynamic Range Diagnostic Immuno-Assay Platforms.

Thu, 07 Sep 2017 00:00:00 GMT-05:00 - Grebe, Eduard; Welte, Alex; Hall, Jake; Keating, Sheila M.; Facente, Shelley N.; Marson, Kara; Martin, Jeffrey N.; Little, Susan J.; Price, Matthew A.; Kallas, Esper G.; Busch, Michael P.; Pilcher, Christopher D.; Murphy, Gary; on behalf of the Consortium for the Evaluation and Performance of HIV Incidence Assays (CEPHIA)
Εισαγωγή: Custom HIV staging assays, including the Sedia(TM) HIV Limiting Antigen Avidity EIA (LAg) and avidity modifications of the Ortho VITROS(R) anti-HIV+2 and Abbott ARCHITECT HIV Ag/Ab Combo assays, are used to identify 'recent' infections in clinical settings and for cross-sectional HIV incidence estimation. However, the high dynamic range of chemiluminescent platforms allows differentiating recent and longstanding infection on signal intensity, and this raises the prospect of using unmodified diagnostic assays for infection timing and surveillance applications.
Μέθοδοι: We tested a panel of 2,500 well-characterised specimens with estimable duration of HIV infection with the three assays and the unmodified ARCHITECT. Regression models were used to estimate mean durations of recent infection (MDRI), context-specific false-recent rates (FRR) and correlation between diagnostic signal intensity and LAg measurements. Hypothetical epidemiological scenarios were constructed to evaluate utility in surveillance applications.
Αποτελέσματα: Over a range of MDRIs (reflecting recency discrimination thresholds), a diluted ARCHITECT-based RITA produced lower FRRs than the VITROS platform (FRR [almost equal to] 0.5% and 1.5% respectively at MDRI [almost equal to] 200 days) and the unmodified diagnostic ARCHITECT produces incidence estimates with comparable precision to LAg (RSE [almost equal to] 17.5% and 15% respectively at MDRI [almost equal to] 200 days). ARCHITECT S/CO measurements were highly correlated with LAg ODn measurements (r = 0.80) and values below 200 are strongly predictive of LAg recency and duration of infection less than one year.
Συμπεράσματα: Low quantitative measurements from the unmodified ARCHITECT obviate the need for additional recency testing and its use is feasible in clinical staging and incidence surveillance applications. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. - (C) 2017

The effect of schooling on age-disparate relationships and number of sexual partners among young women in rural South Africa enrolled in HPTN 068.

Thu, 07 Sep 2017 00:00:00 GMT-05:00 - Stoner, Marie C.D.; Edwards, Jessie K; Miller, William C.; Aiello, Allison E.; Halpern, Carolyn T.; Julien, AimΓ©e; Selin, Amanda; Hughes, James P.; Wang, Jing; Gomez-Olive, F. Xavier; Wagner, Ryan G.; MacPhail, Catherine; Kahn, Kathleen; Pettifor, Audrey
Εισαγωγή: Attending school may have a strong preventative association with sexually transmitted infections among young women, but the mechanism for this relationship is unknown. One hypothesis is that students who attend school practice safer sex with fewer partners, establishing safer sexual networks that make them less exposed to infection. Setting: We used longitudinal data from a randomized controlled trial of young women age 13-20 in the Bushbuckridge district, South Africa, to determine if the percentage of school days attended, school dropout and grade repetition are associated with having a partner five or more years older (age-disparate) and with the number of sexual partners in the previous 12 months.
Μέθοδοι: Risks of having an age-disparate relationship and counts of sex partners were compared using inverse probability of exposure weighted Poisson regression models. Generalized estimating equations were used to account for repeated measures.
Αποτελέσματα: Young women who attended fewer school days (<80%) and who dropped out of school were more likely to have an age-disparate relationship (risk difference (RD) 9.9%, 95% CI 3.9%,16.0%; RD (%) dropout 17.2%, 95% CI: 5.4%,29.0%) and those who dropped out reported having fewer partners (count difference (CD) dropout 0.343, 95% CI: 0.192, 0.495). Grade repetition was not associated with either behavior.
Συμπέρασμα: Young women who less frequently attend school or who drop out are more likely to have an age-disparate relationship. Young women who drop out have more partners overall. These behaviors may increase risk of exposure to HIV infection in young women out of school. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. - (C) 2017