Short communication: Simplified estimation of the long-term specificity of the BED assay to improve estimates of HIV incidence.
The BED assay overestimates HIV incidence because a proportion, epsilon (epsilon), of chronically infected people test "false-recent." In the ZVITAMBO trial, 2796 postpartum women tested HIV positive at baseline and 5.1% tested "false-recent" by BED 12 months later, providing a population-based estimate of epsilon. At baseline, 7.2% (95% CI: 5.3-9.4) of positive women >30 years and 5.1% (95% CI: 3.5-7.2) of positive women with CD4 <200 cells/microl tested "recent" by BED. Thus, the proportions of BED-positive women in either of these subgroups (data that would be available in surveys measuring HIV and BED status) provided a reasonably tight upper bound fo epsilon, which can be used to provide a lower bound for HIV incidence.
Hargrove
John
J
Department of Science and Technology/National Research Foundation Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), University of Stellenbosch, Stellenbosch, South Africa.
Humphrey
Jean
J
D000328:Adult; D018791:CD4 Lymphocyte Count; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006678:HIV / Q000276:immunology*; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D015994:Incidence
D015483:HIV Antibodies