title: Evaluation of an empiric risk screening score to identify acute and early HIV-1 infection among MSM in Coastal Kenya.
abstract: We evaluated the University of North Carolina-Malawi Risk Screening Score (UMRSS) for detection of acute and early HIV-1 infection (AEHI) in a cohort of Kenyan MSM with approximately 8% annual HIV-1 incidence. Three components of the UMRSS (fever, diarrhea, and discordant rapid HIV tests) were also independent predictors of AEHI in our cohort. The predictive ability (area under the receiver operating characteristic curve, AUC) of the UMRSS was 0.79. A cohort-derived risk score consisting of six characteristics (fever, diarrhea, discordant rapid HIV tests, fatigue, age <30 years, and symptomatic sexually transmitted disease) had a higher AUC of 0.85. Screening for AEHI will have substantial transmission prevention benefits.
authors.affiliation: aCentre for Geographic Medicine Research - Coast, Kenya Medical Research Institute - Kilifi, Kilifi, Kenya bNuffield Department of Clinical Medicine, University of Oxford, Headington, UK cInternational AIDS Vaccine Initiative, New York dUniversity of Washington, Seattle, Washington, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Wahome
authors.forename: Greg
authors.initials: G
authors.lastname: Fegan
authors.forename: Haile S
authors.initials: HS
authors.lastname: Okuku
authors.forename: Peter
authors.initials: P
authors.lastname: Mugo
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Price
authors.forename: Grace
authors.initials: G
authors.lastname: Mwashigadi
authors.forename: Alexander
authors.initials: A
authors.lastname: Thiong'o
authors.forename: Susan M
authors.initials: SM
authors.lastname: Graham
authors.forename: Eduard J
authors.initials: EJ
authors.lastname: Sanders
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D018451:Homosexuality, Male; D006801:Humans; D007630:Kenya; D008297:Male; D011237:Predictive Value of Tests; D018570:Risk Assessment / Q000379:methods; D055815:Young Adult