Interpreting HIV diagnostic histories into infection time estimates: analytical framework and online tool

被引：25

作者：

Grebe, Eduard ^{[1
,2
,3
]}

Facente, Shelley N. ^{[1
,3
,4
]}

Bingham, Jeremy ^{[2
]}

Pilcher, Christopher D. ^{[3
,9
]}

Powrie, Andrew ^{[5
]}

Gerber, Jarryd ^{[5
]}

Priede, Gareth ^{[5
]}

Chibawara, Trust ^{[2
,8
]}

Busch, Michael P. ^{[1
,3
]}

Murphy, Gary ^{[6
]}

Kassanjee, Reshma ^{[2
,7
,10
]}

Welte, Alex ^{[2
,8
]}

Sempa, Joseph ^{[8
]}

Matten, David ^{[8
]}

Brand, Hilmarie ^{[8
]}

Chibawara, Trust ^{[2
,8
]}

Murphy, Gary ^{[6
]}

Hall, Jake ^{[6
]}

Mckinney, Elaine ^{[6
]}

Busch, Michael P. ^{[1
,3
]}

Grebe, Eduard ^{[1
,2
,3
]}

Facente, Shelley ^{[1
]}

Hampton, Dylan ^{[1
]}

Keating, Sheila ^{[1
]}

Lebedeva, Mila ^{[1
]}

Pilcher, Christopher D. ^{[3
,9
]}

Marson, Kara ^{[9
]}

Kassanjee, Reshma ^{[2
,7
,10
]}

Laeyendecker, Oliver ^{[11
]}

Quinn, Thomas ^{[11
]}

Burns, David ^{[11
]}

Little, Susan ^{[12
]}

Sands, Anita ^{[13
]}

Hallett, Tim ^{[14
]}

Owen, Sherry Michele ^{[15
]}

Parekh, Bharat ^{[15
]}

Sexton, Connie ^{[15
]}

Price, Matthew ^{[16
]}

Kamali, Anatoli ^{[16
]}

Loeb, Lisa ^{[17
]}

Martin, Jeffrey ^{[18
]}

Deeks, Steven G. ^{[18
]}

Hoh, Rebecca ^{[18
]}

Bartolomei, Zelinda ^{[19
]}

Cerqueira, Natalia ^{[19
,22
]}

Santos, Breno ^{[20
]}

Zabtoski, Kellin ^{[20
]}

Alves Lira, Rita de Cassia ^{[20
]}

Sperhacke, Rosa Dea ^{[21
]}

机构：

[1] Vitalant Res Inst, 270 Masonic Ave, San Francisco, CA 94118 USA

[2] Stellenbosch Univ, DST NRF Ctr Excellence Epidemiol Modelling & Anal, 19 Jonkershoek Ave, ZA-7925 Stellenbosch, South Africa

[3] Univ Calif San Francisco, 1001 Potrero Ave,Room 5H22, San Francisco, CA 94110 USA

[4] Facente Consulting, Richmond, CA USA

[5] Implicit Design, Block B,North Bldg Black River Pk,2 Fir St, ZA-7925 Cape Town, South Africa

[6] Publ Hlth England, 61 Colindale Ave, London NW9 5EQ, England

[7] Univ Cape Town, Fac Hlth Sci, Sch Publ Hlth & Family Med, Ctr Infect Dis Epidemiol & Res, ZA-7925 Cape Town, South Africa

[8] Stellenbosch Univ, South African Ctr Epidemiol Modelling & Anal, Stellenbosch, South Africa

[9] Univ Calif San Francisco, San Francisco, CA 94143 USA

[10] Univ Cape Town, Cape Town, South Africa

[11] NIH, Bldg 10, Bethesda, MD 20892 USA

[12] Univ Calif San Diego, La Jolla, CA 92093 USA

[13] WHO, Geneva, Switzerland

[14] Imperial Coll London, London, England

[15] Ctr Dis Control & Prevent, Atlanta, GA USA

[16] Int AIDS Vaccine Initiat, New York, NY USA

[17] Univ Calif San Francisco, Opt Study, San Francisco, CA 94143 USA

[18] Univ Calif San Francisco, SCOPE Study, San Francisco, CA 94143 USA

[19] Univ Sao Paulo, AMPLIAR Cohort, Sao Paulo, Brazil

[20] Grp Hosp Conceicao, AMPLIAR Cohort, Porto Alegre, RS, Brazil

[21] Univ Caxias Do Sul, AMPLIAR Cohort, Caxias Do Sul, RS, Brazil

[22] Univ Sao Paulo, Sao Paulo Cohort, Sao Paulo, Brazil

[23] Univ Kwazulu Natal, CAPRISA, Durban, South Africa

[24] Barcelona Ctr Int Hlth Res, GAMA Study, Barcelona, Spain

[25] Fundacao Manhica, GAMA Study, Manhica, Mozambique

[26] Asociac Civil Impacta Salud & Educ IMPACTA, SABES Cohort, Lima, Peru

[27] Fred Hutchinson Canc Res Ctr, 1124 Columbia St, Seattle, WA 98104 USA

[28] Natl Inst Infect Dis L Spallanzani, Rome, Italy

[29] Ist Super Sanita, Rome, Italy

[30] Amer Red Cross, Washington, DC 20006 USA

[31] Vitalant Res Inst, Creat Testing Solut, San Francisco, CA USA

[32] South African Natl Blood Serv, Pretoria, South Africa

[33] Hemoctr Sao Paolo, Sao Paulo, Brazil

来源：

BMC INFECTIOUS DISEASES | 2019年 / 19卷 / 01期

基金：

新加坡国家研究基金会; 美国国家卫生研究院;

关键词：

HIV; Infection dating; Infection duration; Infection timing; Diagnostics; Diagnostic assays; SEROCONVERSION; PERFORMANCE; SPECIMENS;

D O I：

10.1186/s12879-019-4543-9

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background It is frequently of epidemiological and/or clinical interest to estimate the date of HIV infection or time-since-infection of individuals. Yet, for over 15 years, the only widely-referenced infection dating algorithm that utilises diagnostic testing data to estimate time-since-infection has been the 'Fiebig staging' system. This defines a number of stages of early HIV infection through various standard combinations of contemporaneous discordant diagnostic results using tests of different sensitivity. To develop a new, more nuanced infection dating algorithm, we generalised the Fiebig approach to accommodate positive and negative diagnostic results generated on the same or different dates, and arbitrary current or future tests - as long as the test sensitivity is known. For this purpose, test sensitivity is the probability of a positive result as a function of time since infection. Methods The present work outlines the analytical framework for infection date estimation using subject-level diagnostic testing histories, and data on test sensitivity. We introduce a publicly-available online HIV infection dating tool that implements this estimation method, bringing together 1) curatorship of HIV test performance data, and 2) infection date estimation functionality, to calculate plausible intervals within which infection likely became detectable for each individual. The midpoints of these intervals are interpreted as infection time 'point estimates' and referred to as Estimated Dates of Detectable Infection (EDDIs). The tool is designed for easy bulk processing of information (as may be appropriate for research studies) but can also be used for individual patients (such as in clinical practice). Results In many settings, including most research studies, detailed diagnostic testing data are routinely recorded, and can provide reasonably precise estimates of the timing of HIV infection. We present a simple logic to the interpretation of diagnostic testing histories into infection time estimates, either as a point estimate (EDDI) or an interval (earliest plausible to latest plausible dates of detectable infection), along with a publicly-accessible online tool that supports wide application of this logic. Conclusions This tool, available at , is readily updatable as test technology evolves, given the simple architecture of the system and its nature as an open source project.

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