Recent HIV infections: evaluation of a simple identification score for newly diagnosed patients
Autor(a) principal: | |
---|---|
Data de Publicação: | 2022 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102022000100228 |
Resumo: | ABSTRACT OBJECTIVE Recognize incident infection to better characterize the groups that fuel HIV epidemic. We propose a simple score to identify recent infections among newly diagnosed patients as a HIV surveillance tool. METHODS Newly diagnosed patients were defined as recent infections when a negative serological test in the previous year was available. Laboratory tests, such as the avidity index (Bio-Rad, according to the CEPHIA protocol), chemiluminescent intensity (CMIA, architect, Abbott), and the nucleotide ambiguity index of partial pol sequences were used as proxies of recency. A simple score based on clinical symptoms of acute retroviral syndrome during the previous year, CD4+ T cell count, and viral load at admission was tested to assess the predictive power, using receiver operating characteristic (ROC) curves, to identify recent cases of infection. RESULTS We evaluated 204 recently diagnosed patients who were admitted to the Ambulatório de Referência em Moléstias Infecciosas de Santo André (Santo André Reference Infectious Diseases Outpatient Clinic), in the metropolitan region of São Paulo, Brazil, recruited between 2011 and 2018. An HIV-negative test in the year prior to enrollment was documented in 37% of participants. The proportion of cases classified as recent infections (less than one year), according to the laboratory proxies were: 37% (67/181) for an avidity index < 40%, 22% (30/137) for a CMIA < 200, and 68% (124/181) for an ambiguity index < 0.5%. Using different combinations of recency definitions, our score showed an area under the ROC curve from 0.66 to 0.87 to predict recency. CONCLUSIONS Using data from patients’ interviews and routine laboratory tests at admission, a simple score may provide information on HIV recency and thus, a proxy for HIV incidence to guide public policies. This simple for the Brazilian public health system and other low- and middle-income countries. |
id |
USP-23_6e6211814f7fc7fd950bc8873879b6d9 |
---|---|
oai_identifier_str |
oai:scielo:S0034-89102022000100228 |
network_acronym_str |
USP-23 |
network_name_str |
Revista de Saúde Pública |
repository_id_str |
|
spelling |
Recent HIV infections: evaluation of a simple identification score for newly diagnosed patientsAcquired Immunodeficiency Syndrome, epidemiologyAIDS Serodiagnosis, classificationEarly DiagnosisTime-to-TreatmentEpidemiologic Surveillance ServicesABSTRACT OBJECTIVE Recognize incident infection to better characterize the groups that fuel HIV epidemic. We propose a simple score to identify recent infections among newly diagnosed patients as a HIV surveillance tool. METHODS Newly diagnosed patients were defined as recent infections when a negative serological test in the previous year was available. Laboratory tests, such as the avidity index (Bio-Rad, according to the CEPHIA protocol), chemiluminescent intensity (CMIA, architect, Abbott), and the nucleotide ambiguity index of partial pol sequences were used as proxies of recency. A simple score based on clinical symptoms of acute retroviral syndrome during the previous year, CD4+ T cell count, and viral load at admission was tested to assess the predictive power, using receiver operating characteristic (ROC) curves, to identify recent cases of infection. RESULTS We evaluated 204 recently diagnosed patients who were admitted to the Ambulatório de Referência em Moléstias Infecciosas de Santo André (Santo André Reference Infectious Diseases Outpatient Clinic), in the metropolitan region of São Paulo, Brazil, recruited between 2011 and 2018. An HIV-negative test in the year prior to enrollment was documented in 37% of participants. The proportion of cases classified as recent infections (less than one year), according to the laboratory proxies were: 37% (67/181) for an avidity index < 40%, 22% (30/137) for a CMIA < 200, and 68% (124/181) for an ambiguity index < 0.5%. Using different combinations of recency definitions, our score showed an area under the ROC curve from 0.66 to 0.87 to predict recency. CONCLUSIONS Using data from patients’ interviews and routine laboratory tests at admission, a simple score may provide information on HIV recency and thus, a proxy for HIV incidence to guide public policies. This simple for the Brazilian public health system and other low- and middle-income countries.Faculdade de Saúde Pública da Universidade de São Paulo2022-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102022000100228Revista de Saúde Pública v.56 2022reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USP10.11606/s1518-8787.2022056004047info:eu-repo/semantics/openAccessMatsuda,Elaine MonteiroAhagon,Cintia MayumiCoelho,Luana Portes OzórioCampos,Ivana Barros deColpas,Daniela RodriguesCarmo,Andreia Moreira dos SantosBrígido,Luís Fernando de Macedoeng2022-05-03T00:00:00Zoai:scielo:S0034-89102022000100228Revistahttp://www.scielo.br/scielo.php?script=sci_serial&pid=0034-8910&lng=pt&nrm=isoONGhttps://old.scielo.br/oai/scielo-oai.phprevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2022-05-03T00:00Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Recent HIV infections: evaluation of a simple identification score for newly diagnosed patients |
title |
Recent HIV infections: evaluation of a simple identification score for newly diagnosed patients |
spellingShingle |
Recent HIV infections: evaluation of a simple identification score for newly diagnosed patients Matsuda,Elaine Monteiro Acquired Immunodeficiency Syndrome, epidemiology AIDS Serodiagnosis, classification Early Diagnosis Time-to-Treatment Epidemiologic Surveillance Services |
title_short |
Recent HIV infections: evaluation of a simple identification score for newly diagnosed patients |
title_full |
Recent HIV infections: evaluation of a simple identification score for newly diagnosed patients |
title_fullStr |
Recent HIV infections: evaluation of a simple identification score for newly diagnosed patients |
title_full_unstemmed |
Recent HIV infections: evaluation of a simple identification score for newly diagnosed patients |
title_sort |
Recent HIV infections: evaluation of a simple identification score for newly diagnosed patients |
author |
Matsuda,Elaine Monteiro |
author_facet |
Matsuda,Elaine Monteiro Ahagon,Cintia Mayumi Coelho,Luana Portes Ozório Campos,Ivana Barros de Colpas,Daniela Rodrigues Carmo,Andreia Moreira dos Santos Brígido,Luís Fernando de Macedo |
author_role |
author |
author2 |
Ahagon,Cintia Mayumi Coelho,Luana Portes Ozório Campos,Ivana Barros de Colpas,Daniela Rodrigues Carmo,Andreia Moreira dos Santos Brígido,Luís Fernando de Macedo |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Matsuda,Elaine Monteiro Ahagon,Cintia Mayumi Coelho,Luana Portes Ozório Campos,Ivana Barros de Colpas,Daniela Rodrigues Carmo,Andreia Moreira dos Santos Brígido,Luís Fernando de Macedo |
dc.subject.por.fl_str_mv |
Acquired Immunodeficiency Syndrome, epidemiology AIDS Serodiagnosis, classification Early Diagnosis Time-to-Treatment Epidemiologic Surveillance Services |
topic |
Acquired Immunodeficiency Syndrome, epidemiology AIDS Serodiagnosis, classification Early Diagnosis Time-to-Treatment Epidemiologic Surveillance Services |
description |
ABSTRACT OBJECTIVE Recognize incident infection to better characterize the groups that fuel HIV epidemic. We propose a simple score to identify recent infections among newly diagnosed patients as a HIV surveillance tool. METHODS Newly diagnosed patients were defined as recent infections when a negative serological test in the previous year was available. Laboratory tests, such as the avidity index (Bio-Rad, according to the CEPHIA protocol), chemiluminescent intensity (CMIA, architect, Abbott), and the nucleotide ambiguity index of partial pol sequences were used as proxies of recency. A simple score based on clinical symptoms of acute retroviral syndrome during the previous year, CD4+ T cell count, and viral load at admission was tested to assess the predictive power, using receiver operating characteristic (ROC) curves, to identify recent cases of infection. RESULTS We evaluated 204 recently diagnosed patients who were admitted to the Ambulatório de Referência em Moléstias Infecciosas de Santo André (Santo André Reference Infectious Diseases Outpatient Clinic), in the metropolitan region of São Paulo, Brazil, recruited between 2011 and 2018. An HIV-negative test in the year prior to enrollment was documented in 37% of participants. The proportion of cases classified as recent infections (less than one year), according to the laboratory proxies were: 37% (67/181) for an avidity index < 40%, 22% (30/137) for a CMIA < 200, and 68% (124/181) for an ambiguity index < 0.5%. Using different combinations of recency definitions, our score showed an area under the ROC curve from 0.66 to 0.87 to predict recency. CONCLUSIONS Using data from patients’ interviews and routine laboratory tests at admission, a simple score may provide information on HIV recency and thus, a proxy for HIV incidence to guide public policies. This simple for the Brazilian public health system and other low- and middle-income countries. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102022000100228 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102022000100228 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.11606/s1518-8787.2022056004047 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Faculdade de Saúde Pública da Universidade de São Paulo |
publisher.none.fl_str_mv |
Faculdade de Saúde Pública da Universidade de São Paulo |
dc.source.none.fl_str_mv |
Revista de Saúde Pública v.56 2022 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1748936506889732096 |