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Medical Microbiology and Immunology

, Volume 208, Issue 5, pp 693–702 | Cite as

Discrimination between recent and non-recent HIV infections using routine diagnostic serological assays

  • Jaythoon HassanEmail author
  • Joanne Moran
  • Gary Murphy
  • Olivia Mason
  • Jeff Connell
  • Cillian De Gascun
Original Investigation

Abstract

The suitability of routine diagnostic HIV assays to accurately discriminate between recent and non-recent HIV infections has not been fully investigated. The aim of this study was to compare an established HIV recency assay, the Sedia limiting antigen HIV avidity assay (LAg), with the diagnostic assays; Abbott ARCHITECT HIV Ag/Ab Combo and INNO-LIA HIV line assays. Samples from all new HIV diagnoses in Ireland from January to December 2016 (n = 455) were tested. An extended logistic regression model, the Spiegelhalter–Knill–Jones method, was utilised to establish a scoring system to predict recency of HIV infection. As proof of concept, 50 well-characterised samples were obtained from the CEPHIA repository whose stage of infection was blinded to the authors, which were tested and analysed. The proportion of samples that were determined as recent was 18.1% for LAg, 6.4% with the ARCHITECT, and 14.5% in the INNO-LIA assay. There was a significant correlation between the ARCHITECT S/CO values and the LAg results, r = 0.717, p < 0.001. ROC analysis revealed that an ARCHITECT S/CO < 250 had a sensitivity and specificity of 90.32% and 89.83%, respectively. Combining the Abbott ARCHITECT HIV Ag/Ab Combo assay and INNO-LIA HIV assays resulted in an observed risk of being recent of 100%. Analysis of the CEPHIA samples revealed a strong agreement between the LAg assay and the combination of routine assays (κ = 0.908, p < 0.001). Our findings provide evidence that assays routinely employed to diagnose and confirm HIV infection may be utilised to determine the recency of HIV infection.

Keywords

HIV infection Recency Routine diagnostic assays 

Notes

Author contributions

Concept and design of the study: JH and JM; acquisition of data: JH and JM, statistical analysis: JH and OM; interpretation of data and drafting the manuscript: JH and JC; critical revision of the manuscript: CDG and GM.

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflict of interest.

Ethical approval

For this type of study, formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.National Virus Reference LaboratoryUniversity College DublinDublin 4Ireland
  2. 2.Health Protection Surveillance CentreDublin 1Ireland
  3. 3.Public Health England, London on Behalf of the Consortium for Performance and Evaluation of HIV Incidence Assays (CEPHIA)LondonUK
  4. 4.Department of Public Health, Physiotherapy and Population Science, Centre for Support and Training in Analysis and ResearchUniversity College DublinDublin 4Ireland

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