Comparison of the Bed-Igg Captured EIA HIV-1 Incidence Assay with the Who-Criteria for Identifying Recently HIV Infected Individuals for Enrollment in the HIVDR-TS

Jemal Ali , Huda Mohammed , Adugna Abera , Yohannes Mengistu , Beverley Singh , Adrian Puren , Dawit Wolday
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DOI: https://doi.org/10.20372/ejhbs.v5i1.202
Submitted: 2021-07-09 08:15:25
Published: 2021-07-14

Background: With the advent of antiretroviral therapy (ART) in several developing countries, WHO has proposed that countries should monitor HIV drug resistance (HIVDR) based on a population-based threshold survey. The guideline uses age-criteria to identify newly infected individuals. The accuracy of such guideline has not been validated, however. 

Objective: To compare the WHO criteria for identifying recently infected individuals with a biological marker HIV-1 BED incidence assay. 

Methods: Individuals were enrolled from the VCT center, Addis Ababa, Ethiopia. Initial HIV screening was done based on current national Rapid HIV screening algorithm. Based on the WHO criteria, HIV-positive was classified as recently infected if less than 25years of age. Moreover the HIV-positive specimens were retested by two conventional EIA tests and discrepant results were confirmed by Western blot test.  Then using the bio-marker HIV-1 BED incidence assay to classify the recent infection for comparison with the WHO-criteria.  

Results: A total of 4492 individuals underwent VCT and screened for HIV. Of these 360 (8.0 %) were found to be HIV-positive; 64 (1.4%) were identified as recently infected based on the WHO criteria. Forty-two (0.93%) were identified as recently infected by the HIV-1 BED incidence assay, giving an estimated incidence of 2.36 % per year [95% CI, 1.7-3.1]. However, the strength of agreement between the WHO criteria and BED assay is considered to be poor to fair K=0.29 (95% CI, 0.11 – 0.47). 

Conclusion: The concordance between WHO criteria and BED assay is low. This shows that whether the WHO criteria over estimate or the BED assay under estimates recent infection (or vice versa) is difficult to identify.  In the absence of current gold-standard to decide which of the above criteria is more accurate, the need for identifying recent HIV infection for the purpose of population based studies is urgent.

 

Keywords

BED IgG CEIA HIV recent infection HIVDR-TS

Authors

Jemal Ali

Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

Huda Mohammed

Management Sciences for Health, Supply Chain Management Systems for HIV/AIDS care, Addis Ababa, Ethiopia

Adugna Abera

Armauer Hansen Research Institute, Addis Ababa, Ethiopia

Yohannes Mengistu

Department of Microbiology, Immunology and Parasitology, Faculty of Medicine, Addis Ababa University, Ethiopia.

Beverley Singh

Department of Virology, National institute for Communicable Diseases, Johannesburg, South Africa

Adrian Puren

Department of Virology, National institute for Communicable Diseases, Johannesburg, South Africa

Dawit Wolday

Medical Biotech Laboratories, Research and training institute, Addis Ababa, Ethiopia

How to Cite

Jemal Ali, Huda Mohammed, Adugna Abera, Yohannes Mengistu, Beverley Singh, Adrian Puren, Dawit Wolday (2021-07-14). Comparison of the Bed-Igg Captured EIA HIV-1 Incidence Assay with the Who-Criteria for Identifying Recently HIV Infected Individuals for Enrollment in the HIVDR-TS. Ethiopian Journal of Health and Biomedical Sciences, Vol. 5 No. 1 (2012), 47-54. https://doi.org/10.20372/ejhbs.v5i1.202

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Copyright © 2021 The Author(s)

Copyright & Licensing © Year The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0) , which permits unrestricted use; sharing (copying and redistributing the material in any medium or format); and adaptation (remixing, transforming, and building upon the material for any purpose), provided the original author(s) and the source are properly cited/credited and a link to the license is provided. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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