title: Viral and Host Characteristics of Recent and Established HIV-1 Infections in Kisumu based on a Multiassay Approach.
abstract: Integrated approaches provide better understanding of HIV/AIDS epidemics. We optimised a multiassay algorithm (MAA) and assessed HIV incidence, correlates of recent infections, viral diversity, plus transmission clusters among participants screened for Kisumu Incidence Cohort Study (KICoS1) (2007-2009). We performed BED-CEIA, Limiting antigen (LAg) avidity, Biorad avidity, and viral load (VL) tests on HIV-positive samples. Genotypic analyses focused on HIV-1 pol gene. Correlates of testing recent by MAA were assessed using logistic regression model. Overall, 133 (12%, 95% CI: 10.2-14.1) participants were HIV-positive, of whom 11 tested recent by MAA (BED-CEIA OD-n < 0.8 + LAg avidity OD-n < 1.5 + VL > 1000 copies/mL), giving an incidence of 1.46% (95% CI: 0.58-2.35) per year. This MAA-based incidence was similar to longitudinal KICoS1 incidence. Correlates of testing recent included sexually transmitted infection (STI) treatment history (OR = 3.94, 95% CI: 1.03-15.07) and syphilis seropositivity (OR = 10.15, 95% CI: 1.51-68.22). Overall, HIV-1 subtype A (63%), D (15%), C (3%), G (1%) and recombinants (18%), two monophyletic dyads and intrinsic viral mutations (V81I, V81I/V, V108I/V and K101Q) were observed. Viral diversity mirrored known patterns in this region, while resistance mutations reflected likely non-exposure to antiretroviral drugs. Management of STIs may help address ongoing HIV transmission in this region.
authors.affiliation: Kenya Medical Research Institute/U.S. CDC Research and Public Health Collaboration (KEMRI/CDC) and KEMRI Center for Global Health Research, Kisumu, Kenya.
authors.forename: Newton
authors.initials: N
authors.lastname: Otecko
authors.affiliation: Kenya Medical Research Institute/U.S. CDC Research and Public Health Collaboration (KEMRI/CDC) and KEMRI Center for Global Health Research, Kisumu, Kenya.
authors.forename: Seth
authors.initials: S
authors.lastname: Inzaule
authors.affiliation: Kenya Medical Research Institute/U.S. CDC Research and Public Health Collaboration (KEMRI/CDC) and KEMRI Center for Global Health Research, Kisumu, Kenya.
authors.forename: Collins
authors.initials: C
authors.lastname: Odhiambo
authors.affiliation: Kenya Medical Research Institute/U.S. CDC Research and Public Health Collaboration (KEMRI/CDC) and KEMRI Center for Global Health Research, Kisumu, Kenya.
authors.forename: George
authors.initials: G
authors.lastname: Otieno
authors.affiliation: Kenya Medical Research Institute/U.S. CDC Research and Public Health Collaboration (KEMRI/CDC) and KEMRI Center for Global Health Research, Kisumu, Kenya.
authors.forename: Valarie
authors.initials: V
authors.lastname: Opollo
authors.affiliation: Kenya Medical Research Institute/U.S. CDC Research and Public Health Collaboration (KEMRI/CDC) and KEMRI Center for Global Health Research, Kisumu, Kenya.
authors.forename: Alex
authors.initials: A
authors.lastname: Morwabe
authors.affiliation: Kenya Medical Research Institute/U.S. CDC Research and Public Health Collaboration (KEMRI/CDC) and KEMRI Center for Global Health Research, Kisumu, Kenya.
authors.forename: Kennedy
authors.initials: K
authors.lastname: Were
authors.affiliation: Kenya Medical Research Institute/U.S. CDC Research and Public Health Collaboration (KEMRI/CDC) and KEMRI Center for Global Health Research, Kisumu, Kenya.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ndiege
authors.affiliation: Kenya Medical Research Institute/U.S. CDC Research and Public Health Collaboration (KEMRI/CDC) and KEMRI Center for Global Health Research, Kisumu, Kenya.
authors.forename: Fredrick
authors.initials: F
authors.lastname: Otieno
authors.affiliation: U.S. Centers for Disease Control and Prevention (CDC-Kenya, Division of HIV/AIDS Prevention) and the KEMRI/CDC Research and Public Health Collaboration, Kisumu, Kenya.
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Kim
authors.affiliation: U.S. Centers for Disease Control and Prevention (CDC-Kenya, Division of HIV/AIDS Prevention) and the KEMRI/CDC Research and Public Health Collaboration, Kisumu, Kenya.
authors.forename: Clement
authors.initials: C
authors.lastname: Zeh
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D005260:Female; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D006679:HIV Seropositivity / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000472:pathogenicity*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012698:Serologic Tests; D055815:Young Adult
chemical_list: D015483:HIV Antibodies