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Figure 1

Figure 1. Use of a multi-assay algorithm (MAA) to identify women with recent HIV infection. From: Association of recent HIV infection and in utero HIV-1 transmission: Findings from the PEPI-Malawi trial.

A multi-assay algorithm (MAA) was used to identify women in the PEPI-Malawi trial who were recently infected with HIV at the time of delivery. In the MAA, women are classified as recently infected if they have the following test results: BED result < 1.0 optical density units (OD-n) + avidity result < 80% + CD4 cell count > 200 cells/mm3 + HIV viral load > 400 copies/ml. The assay cut-offs used for BED and avidity assays in this MAA (1.0 OD-n and 80%, respectively) are higher than the assay cut-offs that are typically used when each these assays is used alone for cross-sectional incidence testing (see below). Most of the women tested (2479/2561=96.8%) were classified as not recently infected based on results from the BED and avidity assays; those women either had a BED assay result >1.0 (N=175), an avidity assay result >80% (N=44) or both (N=2,260). The remaining 82 women had BED and avidity test results below the assay cut-offs, but were classified as not recently infected because they had either a CD4 cell count < 200 cells/mm3 (N=5) or an HIV viral load < 400 copies/ml (N=4). The remaining 73 women (2.9 % of the 2,561 women tested) were classified as recently infected using the MAA.

Taha E. TAHA, et al. AIDS. ;25(11):1357-1364.

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