title: Identifying Recent HIV Infections: From Serological Assays to Genomics.
abstract: In this paper, we review serological and molecular based methods to identify HIV infection recency. The accurate identification of recent HIV infection continues to be an important research area and has implications for HIV prevention and treatment interventions. Longitudinal cohorts that follow HIV negative individuals over time are the current gold standard approach, but they are logistically challenging, time consuming and an expensive enterprise. Methods that utilize cross-sectional testing and biomarker information have become an affordable alternative to the longitudinal approach. These methods use well-characterized biological makers to differentiate between recent and established HIV infections. However, recent results have identified a number of limitations in serological based assays that are sensitive to the variability in immune responses modulated by HIV subtypes, viral load and antiretroviral therapy. Molecular methods that explore the dynamics between the timing of infection and viral evolution are now emerging as a promising approach. The combination of serological and molecular methods may provide a good solution to identify recent HIV infection in cross-sectional data. As part of this review, we present the advantages and limitations of serological and molecular based methods and their potential complementary role for the identification of HIV infection recency.
authors.affiliation: Division of Medical Virology, Stellenbosch University, Tygerberg 7505, South Africa. sikhulilemoyo@gmail.com.|Botswana-Harvard AIDS Institute Partnership, Private Bag BO320, Gaborone, Botswana. sikhulilemoyo@gmail.com.
authors.forename: Sikhulile
authors.initials: S
authors.lastname: Moyo
authors.affiliation: Africa Centre for Health and Population Studies, Doris Duke Medical Research Centre, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban 4041, South Africa. ewilkinson83@gmail.com.
authors.forename: Eduan
authors.initials: E
authors.lastname: Wilkinson
authors.affiliation: Botswana-Harvard AIDS Institute Partnership, Private Bag BO320, Gaborone, Botswana. vnovi@hsph.harvard.edu.|Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA. vnovi@hsph.harvard.edu.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Novitsky
authors.affiliation: Africa Centre for Health and Population Studies, Doris Duke Medical Research Centre, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban 4041, South Africa. vando026@umn.edu.
authors.forename: Alain
authors.initials: A
authors.lastname: Vandormael
authors.affiliation: Botswana-Harvard AIDS Institute Partnership, Private Bag BO320, Gaborone, Botswana. sgaseitsiwe@bhp.org.bw.|Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA. sgaseitsiwe@bhp.org.bw.
authors.forename: Simani
authors.initials: S
authors.lastname: Gaseitsiwe
authors.affiliation: Botswana-Harvard AIDS Institute Partnership, Private Bag BO320, Gaborone, Botswana. messex@hsph.harvard.edu.|Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA. messex@hsph.harvard.edu.
authors.forename: Max
authors.initials: M
authors.lastname: Essex
authors.affiliation: Division of Medical Virology, Stellenbosch University, Tygerberg 7505, South Africa. susanen@sun.ac.za.|National Health Laboratory Services (NHLS), Tygerberg Coastal, Johannesburg 2001, South Africa. susanen@sun.ac.za.
authors.forename: Susan
authors.initials: S
authors.lastname: Engelbrecht
authors.affiliation: Africa Centre for Health and Population Studies, Doris Duke Medical Research Centre, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban 4041, South Africa. tdeoliveira@africacentre.ac.za.|Research Department of Infection, University College London, London WC1E 6BT, UK. tdeoliveira@africacentre.ac.za.|College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa. tdeoliveira@africacentre.ac.za.
authors.forename: Tulio
authors.initials: T
authors.lastname: de Oliveira
mesh_terms: D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D008137:Longitudinal Studies; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D012698:Serologic Tests / Q000379:methods*
keywords: molecular-based assays; recent HIV infection; serology-based assays; viral diversity