Hofmann Alexandra, Hauser Andrea, Zimmermann Ruth, Santos-Hövener Claudia, Bätzing-Feigenbaum Jörg, Wildner Stephan, Kücherer Claudia, Bannert Norbert, Hamouda Osamah, Bremer Viviane, Bartmeyer Barbara
Department for Infectious Disease Epidemiology, Unit 34 HIV/AIDS, STI and Blood-Borne Infections, Robert Koch-Institute, Seestr.10, 13353, Berlin, Germany.
Charité, Universitätsmedizin, Berlin, Germany.
BMC Infect Dis. 2017 Jul 11;17(1):484. doi: 10.1186/s12879-017-2585-4.
The HIV surveillance system in Germany is based on mandatory, anonymous notification of newly diagnosed HIV cases by laboratories. Because the time between HIV infection and the diagnosis of HIV varies widely between persons, it is difficult to determine the number of cases of recent HIV infection among newly diagnosed cases of HIV. In Germany, the BED-capture-enzyme immunoassay (BED-CEIA) has been used to distinguish between recent and long-standing HIV infection. The aim of this analysis is to report the proportion of cases of recent HIV infection among newly diagnosed cases in Germany between 2008 and 2014 and to identify factors associated with recent infections.
A sample of voluntary laboratories among all HIV diagnostic laboratories was recruited. Residual blood from HIV diagnostic tests was spotted on filter paper as dried serum or dried plasma spots and was sent along with the notification form of the HIV cases. The BED-CEIA test was performed. A case was defined as recent HIV infection with a BED-CEIA test result of less than 0.8 normalized optical density, with the exclusion of CDC stage C. The proportion of recent newly diagnosed HIV infections among different groups (such as transmission groups, gender or age groups) was calculated. We used logistic regression to identify factors associated with recent HIV infection and to identify subpopulations with high proportions of recent HIV infections.
Approximately 10,257 newly diagnosed cases were tested for recency using the BED-CEIA. In total, 3084 (30.4%) of those were recently infected with HIV. The highest proportion of recent HIV infections was found among men who had sex with men (MSM) (35%) and persons between 18 and 25 years of age (43.0%). Logistic regression revealed that female German intravenous drug users with a recent HIV infection had a higher chance of being detected than German MSM (OR 2.27).
Surveillance of recent HIV infection is a useful additional tool to monitor the HIV epidemic in Germany. We could observe ongoing HIV transmission in Germany in general and in different subgroups, and we could identify factors associated with recent HIV infection in Germany.
德国的艾滋病毒监测系统基于实验室对新诊断出的艾滋病毒病例进行强制性匿名通报。由于艾滋病毒感染与艾滋病毒诊断之间的时间间隔在不同个体之间差异很大，因此很难确定新诊断出的艾滋病毒病例中近期感染艾滋病毒的病例数。在德国，BED捕获酶免疫测定法（BED-CEIA）已被用于区分近期和长期艾滋病毒感染。本分析的目的是报告2008年至2014年德国新诊断病例中近期感染艾滋病毒病例的比例，并确定与近期感染相关的因素。
在所有艾滋病毒诊断实验室中招募了一批自愿参与的实验室。将艾滋病毒诊断检测的剩余血液点在滤纸上制成干血清或干血浆斑，并与艾滋病毒病例通报表一起送检。进行BED-CEIA检测。病例定义为BED-CEIA检测结果归一化光密度小于0.8的近期艾滋病毒感染，不包括疾病控制与预防中心（CDC）C期。计算不同组（如传播组、性别或年龄组）中近期新诊断出的艾滋病毒感染的比例。我们使用逻辑回归来确定与近期艾滋病毒感染相关的因素，并确定近期艾滋病毒感染比例高的亚人群。
约10257例新诊断病例使用BED-CEIA进行了近期感染检测。其中，共有3084例（30.4%）近期感染了艾滋病毒。近期艾滋病毒感染比例最高的是男男性行为者（MSM）（35%）和18至25岁的人群（43.0%）。逻辑回归显示，近期感染艾滋病毒的德国女性静脉吸毒者被检测到的几率高于德国男男性行为者（比值比2.27）。
近期艾滋病毒感染监测是监测德国艾滋病毒流行情况的一个有用的补充工具。我们可以观察到德国总体上以及不同亚组中持续的艾滋病毒传播情况，并且可以确定德国与近期艾滋病毒感染相关的因素。
