Gonese Elizabeth, Musuka Godfrey, Ruangtragool Leala, Hakim Avi, Parekh Bharat, Dobbs Trudy, Duong Yen T, Patel Hetal, Mhangara Mutsa, Mugurungi Owen, Mapingure Munyaradzi, Saito Suzue, Herman-Roloff Amy, Gwanzura Lovemore, Tippett-Barr Beth, Kilmarx Peter H, Justman Jessica
Division of Global AIDS and TB, U.S. Centers for Disease Control and Prevention, Harare, Zimbabwe.
ICAP at Columbia University, Harare, Zimbabwe.
AIDS Res Hum Retroviruses. 2020 Aug;36(8):656-662. doi: 10.1089/AID.2020.0046. Epub 2020 Jun 29.
Between October 2015 and August 2016, Zimbabwe conducted the Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA) cross-sectional survey to determine progress toward epidemic control. Of 25,131 eligible adults aged 15-64 years, 20,577 (81.8%) consented to face-to-face questionnaire and biomarker testing in this nationally representative household survey. Home-based rapid HIV testing was performed using Determine, First Response, and STAT-PAK as the tiebreaker. HIV-positive tests were confirmed in a laboratory using Geenius HIV-1/2; viral load (VL) was measured using Roche TaqMan and BioMerieux NucliSENS. Recency of infection was tested using Sedia HIV-1 Limiting Antigen (LAg)-Avidity. Presence of antiretroviral (ARV) drugs was detected using high performance liquid chromatography/mass spectrometry (HPLC/MS). The recent infection testing algorithm included LAg-avidity enzyme immunoassay [normalized optical density (ODn ≤1.5), VL ≥1,000 copies/mL, and absence of ARV drugs]. Weighted annual HIV incidence was compared with United Nations Joint Programme on HIV/AIDS (UNAIDS) Spectrum models estimates. Overall, 26 of 2,901 HIV-seropositive individuals had a recent infection (men, 8; women, 18). Overall weighted annual incidence among persons aged 15-64 years was 0.42% [95% confidence interval (CI): 0.25-0.59] and was 0.44% (95% CI: 0.25-0.62) for those aged 15-49 years, similar to 2016 Spectrum model estimate (0.54%, 95% CI: 0.49-0.66) for this age group. Among persons aged 15-49 years, HIV prevalence was 13.35% (95% CI: 12.71-14.02), estimated HIV-positive individuals were 968,951 (95% CI: 911,473-1,026,430), of these, 41,911 (95% CI: 37,412-44,787) were annual-new infections, and this was similar to 2016 Spectrum estimates. The observed HIV incidence in ZIMPHIA 2015-2016 validated the 2016 Spectrum estimates and Zimbabwe's progress toward epidemic control.
2015年10月至2016年8月期间，津巴布韦开展了基于人口的津巴布韦艾滋病毒影响评估（ZIMPHIA）横断面调查，以确定在疫情控制方面取得的进展。在25131名符合条件的15至64岁成年人中，20577人（81.8%）同意在这项具有全国代表性的家庭调查中接受面对面问卷调查和生物标志物检测。在家中使用Determine、First Response和STAT-PAK进行快速艾滋病毒检测，以其中结果作为最终判定依据。艾滋病毒阳性检测结果在实验室使用Geenius HIV-1/2进行确认；病毒载量（VL）使用罗氏TaqMan和生物梅里埃NucliSENS进行测量。使用Sedia HIV-1限量抗原（LAg）-亲和力检测感染近期情况。使用高效液相色谱/质谱法（HPLC/MS）检测抗逆转录病毒（ARV）药物的存在情况。近期感染检测算法包括LAg-亲和力酶免疫测定[标准化光密度（ODn≤1.5）、VL≥1000拷贝/毫升且无ARV药物]。将加权年度艾滋病毒发病率与联合国艾滋病毒/艾滋病联合规划署（UNAIDS）Spectrum模型估计值进行比较。总体而言，在2901名艾滋病毒血清阳性个体中，有26人近期感染（男性8人；女性18人）。15至64岁人群的总体加权年度发病率为0.42%[95%置信区间（CI）：0.25-0.59]，15至49岁人群为0.44%（95%CI：0.25-0.62），与该年龄组2016年Spectrum模型估计值（0.54%，95%CI：0.49-0.66）相似。在15至49岁人群中，艾滋病毒患病率为13.35%（95%CI：12.71-14.02），估计艾滋病毒阳性个体为968951人（95%CI：911473-1026430），其中41911人（95%CI：37412-44787）为年度新感染病例，这与2016年Spectrum估计值相似。2015-2016年ZIMPHIA中观察到的艾滋病毒发病率验证了2016年Spectrum估计值以及津巴布韦在疫情控制方面取得的进展。
