title: Mean Recency Period for Estimation of HIV-1 Incidence with the BED-Capture EIA and Bio-Rad Avidity in Persons Diagnosed in the United States with Subtype B.
abstract: HIV incidence estimates are used to monitor HIV-1 infection in the United States. Use of laboratory biomarkers that distinguish recent from longstanding infection to quantify HIV incidence rely on having accurate knowledge of the average time that individuals spend in a transient state of recent infection between seroconversion and reaching a specified biomarker cutoff value. This paper describes five estimation procedures from two general statistical approaches, a survival time approach and an approach that fits binomial models of the probability of being classified as recently infected, as a function of time since seroconversion. We compare these procedures for estimating the mean duration of recent infection (MDRI) for two biomarkers used by the U.S. National HIV Surveillance System for determination of HIV incidence, the Aware BED EIA HIV-1 incidence test (BED) and the avidity-based, modified Bio-Rad HIV-1/HIV-2 plus O ELISA (BRAI) assay. Collectively, 953 specimens from 220 HIV-1 subtype B seroconverters, taken from 5 cohorts, were tested with a biomarker assay. Estimates of MDRI using the non-parametric survival approach were 198.4 days (SD 13.0) for BED and 239.6 days (SD 13.9) for BRAI using cutoff values of 0.8 normalized optical density and 30%, respectively. The probability of remaining in the recent state as a function of time since seroconversion, based upon this revised statistical approach, can be applied in the calculation of annual incidence in the United States.
authors.affiliation: Quantitative Sciences and Data Management Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Hanson
authors.affiliation: Quantitative Sciences and Data Management Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Ruiguang
authors.initials: R
authors.lastname: Song
authors.affiliation: Laboratory Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Silvina
authors.initials: S
authors.lastname: Masciotra
authors.affiliation: HIV Incidence and Case Surveillance Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Angela
authors.initials: A
authors.lastname: Hernandez
authors.affiliation: International Laboratory Branch, Division of Global HIV and AIDS, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Trudy L
authors.initials: TL
authors.lastname: Dobbs
authors.affiliation: International Laboratory Branch, Division of Global HIV and AIDS, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Bharat S
authors.initials: BS
authors.lastname: Parekh
authors.affiliation: Laboratory Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: S Michele
authors.initials: SM
authors.lastname: Owen
authors.affiliation: Quantitative Sciences and Data Management Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Green
mesh_terms: D015492:AIDS Serodiagnosis; D000915:Antibody Affinity; D015415:Biomarkers / Q000032:analysis*; D002986:Clinical Trials as Topic; D005500:Follow-Up Studies; D015488:HIV Antigens / Q000276:immunology*; D015658:HIV Infections / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D006679:HIV Seropositivity; D015497:HIV-1 / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D007124:Immunoenzyme Techniques; D015994:Incidence; D008137:Longitudinal Studies; D011379:Prognosis; D012698:Serologic Tests; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D019562:Viral Load
chemical_list: D015415:Biomarkers; D015488:HIV Antigens