Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Indian J Med Res. 2020 Sep;152(3):227-233. doi: 10.4103/ijmr.IJMR_2007_18.
BACKGROUND & OBJECTIVES: Being more efficient and widely used, limiting antigen (LAg)-avidity enzyme immunoassay (EIA) based on the recent infection testing algorithm (RITA) has been developed for differentiating recent and established HIV-1 infection. So far, LAg-avidity EIA has not been validated among the Indian population. Hence, the present study was planned to identify recent HIV infections in high risk patients in the North-West region of India using modified LAg-avidity RITA.
Four hundred HIV-positive high risk patients registered on pre-antiretroviral therapy (ART) programme in the last one year, from five ART centres in North-Western States of India, were included for identifying the recent HIV infections. One hundred HIV-positive cases registered for pre-ART for greater than two years in ART centres were included for estimating false recent rate (FRR). Single-well LAg-avidity EIA-based modified RITA was used to identify recent HIV infection cases.
Of the 400 HIV-1-positive samples, 64 (16%) were found to have been infected within the past 130 days. The proportion of recent HIV infections was 16.8 per cent (18/107) among female sex workers, 10.7 per cent (9/84) among men who have sex with men and 17.7 per cent (37/209) among injecting drug users. The FRR was one per cent (1/100).
INTERPRETATION & CONCLUSIONS: LAg-avidity EIA-based modified RITA provided good discrimination between recent and non-recent HIV infection, hence, it could be considered suitable for estimating HIV incidence in sentinel surveillance system in India.
基于最近感染检测算法（RITA）的更有效和广泛应用的限制抗原（LAg）亲合力酶免疫分析（EIA）已被开发用于区分近期和已建立的 HIV-1 感染。到目前为止，LAg 亲合力 EIA 尚未在印度人群中得到验证。因此，本研究计划使用改良的 LAg 亲合力 RITA 在印度西北部地区的高危患者中识别近期 HIV 感染。
从印度西北部五个 ART 中心登记的过去一年中接受抗逆转录病毒治疗（ART）前方案的 400 名 HIV 阳性高危患者中，纳入本研究以识别近期 HIV 感染。纳入在 ART 中心登记接受 ART 前大于两年的 100 名 HIV 阳性病例，以估计假近期率（FRR）。使用基于单孔 LAg 亲合力 EIA 的改良 RITA 来识别近期 HIV 感染病例。
在 400 份 HIV-1 阳性样本中，有 64 份（16%）被发现是在过去 130 天内感染的。女性性工作者中近期 HIV 感染的比例为 16.8%（18/107），男男性行为者中为 10.7%（9/84），注射吸毒者中为 17.7%（37/209）。FRR 为 1%（1/100）。
基于 LAg 亲合力 EIA 的改良 RITA 可很好地区分近期和非近期 HIV 感染，因此，它可考虑用于在印度的哨点监测系统中估计 HIV 发病率。
