OBJECTIVE: To assess the addition of HIV nucleic acid testing (NAT) to fourth-generation (4thG) HIV antigen/antibody combination immunoassay in improving detection of acute HIV infection (AHI). METHODS: Participants attending a major voluntary counseling and testing site in Thailand were screened for AHI using 4thG HIV antigen/antibody immunoassay and sequential less sensitive HIV antibody immunoassay. Samples nonreactive by 4thG antigen/antibody immunoassay were further screened using pooled NAT to identify additional AHI. HIV infection status was verified following enrollment into an AHI study with follow-up visits and additional diagnostic tests. RESULTS: Among 74 334 clients screened for HIV infection, HIV prevalence was 10.9% and the overall incidence of AHI (N = 112) was 2.2 per 100 person-years. The inclusion of pooled NAT in the testing algorithm increased the number of acutely infected patients detected, from 81 to 112 (38%), relative to 4thG HIV antigen/antibody immunoassay. Follow-up testing within 5 days of screening marginally improved the 4thG immunoassay detection rate (26%). The median CD4 T-cell count at the enrollment visit was 353 cells/μl and HIV plasma viral load was 598 289 copies/ml. CONCLUSION: The incorporation of pooled NAT into the HIV testing algorithm in high-risk populations may be beneficial in the long term. The addition of pooled NAT testing resulted in an increase in screening costs of 22% to identify AHI: from $8.33 per screened patient to $10.16. Risk factors of the testing population should be considered prior to NAT implementation given the additional testing complexity and costs.
OBJECTIVE: To assess the addition of HIV nucleic acid testing (NAT) to fourth-generation (4thG) HIV antigen/antibody combination immunoassay in improving detection of acute HIV infection (AHI). METHODS:Participants attending a major voluntary counseling and testing site in Thailand were screened for AHI using 4thG HIV antigen/antibody immunoassay and sequential less sensitive HIV antibody immunoassay. Samples nonreactive by 4thG antigen/antibody immunoassay were further screened using pooled NAT to identify additional AHI. HIV infection status was verified following enrollment into an AHI study with follow-up visits and additional diagnostic tests. RESULTS: Among 74 334 clients screened for HIV infection, HIV prevalence was 10.9% and the overall incidence of AHI (N = 112) was 2.2 per 100 person-years. The inclusion of pooled NAT in the testing algorithm increased the number of acutely infectedpatients detected, from 81 to 112 (38%), relative to 4thG HIV antigen/antibody immunoassay. Follow-up testing within 5 days of screening marginally improved the 4thG immunoassay detection rate (26%). The median CD4 T-cell count at the enrollment visit was 353 cells/μl and HIV plasma viral load was 598 289 copies/ml. CONCLUSION: The incorporation of pooled NAT into the HIV testing algorithm in high-risk populations may be beneficial in the long term. The addition of pooled NAT testing resulted in an increase in screening costs of 22% to identify AHI: from $8.33 per screened patient to $10.16. Risk factors of the testing population should be considered prior to NAT implementation given the additional testing complexity and costs.
Authors: Shuying S Li; Andrew Hickey; Shida Shangguan; Philip K Ehrenberg; Aviva Geretz; Lauryn Butler; Gautam Kundu; Richard Apps; Matthew Creegan; Robert J Clifford; Suteeraporn Pinyakorn; Leigh Anne Eller; Pikunchai Luechai; Peter B Gilbert; Timothy H Holtz; Anupong Chitwarakorn; Carlo Sacdalan; Eugène Kroon; Nittaya Phanuphak; Mark de Souza; Jintanat Ananworanich; Robert J O'Connell; Merlin L Robb; Nelson L Michael; Sandhya Vasan; Rasmi Thomas Journal: Cell Host Microbe Date: 2022-07-15 Impact factor: 31.316
Authors: Thembi Mdluli; Yifan Li; Suteeraporn Pinyakorn; Daniel B Reeves; E Fabian Cardozo-Ojeda; Adam Yates; Jintana Intasan; Somporn Tipsuk; Nittaya Phanuphak; Carlo Sacdalan; Donn J Colby; Eugène Kroon; Trevor A Crowell; Rasmi Thomas; Merlin L Robb; Jintanat Ananworanich; Mark de Souza; Praphan Phanuphak; Daniel J Stieh; Frank L Tomaka; Lydie Trautmann; Julie A Ake; Denise C Hsu; Leilani V Francisco; Sandhya Vasan; Morgane Rolland Journal: Med (N Y) Date: 2022-07-22
Authors: Ornella Sortino; Nittaya Phanuphak; Alexandra Schuetz; Alexandra M Ortiz; Nitiya Chomchey; Yasmine Belkaid; Jacquice Davis; Harry A Mystakelis; Mariam Quiñones; Claire Deleage; Brian Ingram; Rungsun Rerknimitr; Suteeraporn Pinyakorn; Adam Rupert; Merlin L Robb; Jintanat Ananworanich; Jason Brenchley; Irini Sereti Journal: Open Forum Infect Dis Date: 2019-08-21 Impact factor: 3.835