National AIDS Reference Laboratory, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122, China.
Department of AIDS Control and Prevention, Dehong Prefecture Center for Disease Control and Prevention, Mangshi 678400, Yunnan, China.
Int J Infect Dis. 2020 Dec;101:131-137. doi: 10.1016/j.ijid.2020.09.1421. Epub 2020 Sep 26.
Recent infection testing algorithms (RITAs) incorporating clinical information with the HIV recency assay have been proven to accurately classify recent infection. However, little evidence exists on whether RITAs would help in precisely identifying major drivers of the ongoing HIV epidemic.
HIV recency test results and clinical information were collected from 1152 newly diagnosed HIV cases between 2015 and 2017 in Dehong prefecture of Yunnan province, and the efficacy of four different RITAs in identifying risk factors for new HIV infection was compared.
RITA 1 uses the recency test only. RITA 2 and RITA 3 combine the recency test with CD4+ T cell count and viral load (VL), respectively. RITA 4 combines both CD4+ T cell count and VL. All RITAs identified the MSM group and young people between 15 and 24 years as risk factors for incident HIV infection. RITA 3 and RITA 4 further identified the Dai ethnic minority as a risk factor, which had not been identified before when only the HIV recency test was used.
By comparing different RITAs, we determined that greater accuracy in classifying recent HIV infection could help elucidate major drivers impacting the ongoing epidemic and thus inform targeted interventions.
最近的感染检测算法（RITAs）结合了临床信息和 HIV 近期检测，已被证明能够准确地对近期感染进行分类。然而，关于 RITAs 是否有助于精确识别当前 HIV 流行的主要驱动因素，证据有限。
收集了 2015 年至 2017 年云南省德宏州新诊断的 1152 例 HIV 感染者的 HIV 近期检测结果和临床信息，并比较了四种不同 RITAs 在识别新感染 HIV 的风险因素方面的效果。
RITA1 仅使用近期检测。RITA2 和 RITA3 分别将近期检测与 CD4+T 细胞计数和病毒载量（VL）相结合。RITA4 将 CD4+T 细胞计数和 VL 都结合在一起。所有 RITAs 都确定了男男性行为者（MSM）群体和 15-24 岁的年轻人是新感染 HIV 的风险因素。RITA3 和 RITA4 还进一步确定了傣族少数民族是一个风险因素，这在仅使用 HIV 近期检测时没有被识别出来。
通过比较不同的 RITAs，我们确定了更准确地对近期 HIV 感染进行分类可以帮助阐明影响当前流行的主要驱动因素，从而为有针对性的干预措施提供信息。
