title: Use of a multifaceted approach to analyze HIV incidence in a cohort study of women in the United States: HIV Prevention Trials Network 064 Study.
abstract: BACKGROUND
  Reliable methods for estimating the incidence of human immunodeficiency virus (HIV) infection are needed to monitor the epidemic, identify at-risk populations, and evaluate HIV prevention strategies. We used a multifaceted approach to estimate HIV incidence in the HIV Prevention Trials Network (HPTN) 064 study.
  
  
  METHODS
  The HPTN 064 study enrolled 2067 HIV-seronegative women and 32 HIV-seropositive women with no prior HIV infection diagnosis. Women were followed for up to 12 months. HIV incidence estimates were based on (1) detection of acute HIV infection, (2) documentation of HIV seroconversion, and (3) detection of recent HIV infection, using a multiassay algorithm (MAA).
  
  
  RESULTS
  Two women had acute HIV infection at enrollment, 4 seroconverted, and 2 were identified as recently infected at enrollment using the MAA. The annual HIV incidence estimate based on acute infection at enrollment (2.52% [95% confidence interval {CI}, .17%-9.33%], using a 14-day window period) was higher than the estimate based on seroconversion (0.24% [95% CI, .07%-.62%]; P = .027). Incidence estimates obtained using the MAA at enrollment and at the end of study were 0.25% (95% CI, .03%-.93%) and 0.13% (95% CI, .006%-.76%), respectively.
  
  
  CONCLUSIONS
  We detected a high frequency of acute infection at enrollment. Cross-sectional HIV incidence estimates obtained using the MAA were similar to the longitudinal estimate based on HIV seroconversion.
  
  
  BACKGROUND
  NCT00995176.
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. seshlem@jhmi.edu
authors.forename: Susan H
authors.initials: SH
authors.lastname: Eshleman
authors.forename: James P
authors.initials: JP
authors.lastname: Hughes
authors.forename: Oliver
authors.initials: O
authors.lastname: Laeyendecker
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Ron
authors.initials: R
authors.lastname: Brookmeyer
authors.forename: LeTanya
authors.initials: L
authors.lastname: Johnson-Lewis
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Mullis
authors.forename: John
authors.initials: J
authors.lastname: Hackett
authors.forename: Ana S
authors.initials: AS
authors.lastname: Vallari
authors.forename: Jessica
authors.initials: J
authors.lastname: Justman
authors.forename: Sally
authors.initials: S
authors.lastname: Hodder
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D015331:Cohort Studies; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D015994:Incidence; D055815:Young Adult
chemical_list: D015483:HIV Antibodies