Format

Send to

Choose Destination
See comment in PubMed Commons below
AIDS. 2007 Nov 12;21(17):2309-14.

Serological testing algorithm shows rising HIV incidence in a UK cohort of men who have sex with men: 10 years application.

Author information

1
Department of HIV and Genitourinary Medicine, Brighton and Sussex University Hospitals, Eastern Road, Brighton, BN2 5BE, UK. martin.fisher@bsuh.nhs.uk

Abstract

OBJECTIVES:

To investigate whether combining clinical data with the serological testing algorithm for recent HIV seroconversion (STARHS) reliably identifies otherwise unrecognized recent infections and observe their trends.

DESIGN:

Incorporation of STARHS into routine HIV diagnosis.

METHODS:

STARHS was applied to serum collected between 1996 and 2005 at HIV diagnosis and routine clinical/laboratory markers of recent infections were determined. The recent infections were identified by conventional means, by STARHS, and by both combined.

RESULTS:

Of 1526 infections diagnosed, 812 were new. Of these, 604 were in men who have sex with men (MSM); 208 in heterosexuals; 88% had serum available for STARHS, which identified 88 incident infections that would otherwise have been unrecognized (12% of all new infections, 34% of all recent infections). Of these, 88% reported recent high-risk sex; 47% reported seroconversion symptoms. STARHS confirmed recent infections in 71 of 74 (96%) known to be infected within 6 months by conventional methods. Combining both approaches, recent infections increased over time from 26% (1996) to 45% (2005) [P < 0.001]. STARHS results from 3% new diagnoses and 8% previous diagnoses were deemed false incident (associated with antiretroviral therapy, advanced disease or undetectable viral load). False incident results were only inexplicable in two individuals.

CONCLUSION:

Adjunctive use of STARHS with clinical data identified a high and increasing proportion of new HIV diagnoses as recent infections, confirming significant ongoing transmission. Since 2002, 50% of new diagnoses among MSM were recent infections. Identification of additional recent infections by STARHS enables effective intervention that may benefit the individual and reduce onward transmission.

PMID:
18090279
DOI:
10.1097/QAD.0b013e3282ef9fed
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments

    Supplemental Content

    Full text links

    Icon for Wolters Kluwer
    Loading ...
    Support Center