Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland.
J Acquir Immune Defic Syndr. 2021 Oct 1;88(2):117-124. doi: 10.1097/QAI.0000000000002745.
Migrant populations are overrepresented among persons diagnosed with HIV in the European Union and the European Economic Area. Understanding the timing of HIV acquisition (premigration or postmigration) is crucial for developing public health interventions and for producing reliable estimates of HIV incidence and the number of people living with undiagnosed HIV infection. We summarize a recently proposed method for determining the timing of HIV acquisition and apply it to both real and simulated data.
The considered method combines estimates from a mixed model, applied to data from a large seroconverters' cohort, with biomarker measurements and individual characteristics to derive probabilities of premigration HIV acquisition within a Bayesian framework. The method is applied to a subset of data from the European Surveillance System (TESSy) and simulated data.
Simulation study results showed good performance with the probabilities of correctly classifying a premigration case or a postmigration case being 87.4% and 80.4%, respectively. Applying the method to TESSy data, we estimated the proportions of migrants who acquired HIV in the destination country were 31.9%, 37.1%, 45.3%, and 45.2% for those originating from Africa, Europe, Asia, and other regions, respectively.
Although the considered method was initially developed for cases with multiple biomarkers' measurements, its performance, when applied to data where only one CD4 count per individual is available, remains satisfactory. Application of the method to TESSy data, estimated that a substantial proportion of HIV acquisition among migrants occurs in destination countries, having important implications for public health policy and programs.
在欧盟和欧洲经济区，被诊断出感染艾滋病毒的移民人口比例过高。了解艾滋病毒感染的时间（移民前或移民后）对于制定公共卫生干预措施以及产生可靠的艾滋病毒发病率和未确诊艾滋病毒感染人数估计数至关重要。我们总结了一种最近提出的确定艾滋病毒感染时间的方法，并将其应用于真实和模拟数据。
所考虑的方法结合了应用于大型血清转化者队列数据的混合模型的估计值，以及生物标志物测量值和个体特征，以便在贝叶斯框架内得出移民前艾滋病毒感染的可能性。该方法应用于欧洲监测系统（TESSy）的一部分数据和模拟数据。
模拟研究结果表明，该方法的性能良好，正确分类移民前病例或移民后病例的概率分别为 87.4%和 80.4%。将该方法应用于 TESSy 数据，我们估计，原籍来自非洲、欧洲、亚洲和其他地区的移民中，分别有 31.9%、37.1%、45.3%和 45.2%的人在目的地国家感染艾滋病毒。
尽管所考虑的方法最初是为具有多个生物标志物测量值的病例开发的，但当应用于仅每个个体有一个 CD4 计数的情况下，其性能仍然令人满意。该方法应用于 TESSy 数据，估计移民中相当一部分艾滋病毒感染发生在目的地国家，这对公共卫生政策和规划具有重要意义。
