Kin-On Lau Joseph, Murdock Nicholas, Murray Jeffrey, Justman Jessica, Parkin Neil, Miller Veronica
Forum for Collaborative Research, 1608 Rhode Island Avenue NW, Suite 212, Washington, DC, 20036, USA.
ICAP Columbia University Mailman School of Public Health, 722 West 168 Street, New York, NY, 10032, USA.
J Virus Erad. 2022 Sep 7;8(3):100085. doi: 10.1016/j.jve.2022.100085. eCollection 2022 Sep.
The need for detection of new and recent HIV infections is essential for surveillance and assessing interventions in controlling the epidemic. HIV recency assays are one way of providing reliable incidence estimates by determining recent versus non-recent infection. The objective of this study was to review the current body of knowledge of the limiting antigen avidity enzyme immunoassay to expand supported applications through an assessment of what is known and the gaps.
A search for peer-reviewed literature in PubMed, Embase, and Web of Science Core Collection was conducted using the search term "human immunodeficiency virus and avidity". Non-peer reviewed published reports from the Population-based HIV Impact Assessment Project were also included. These were limited to literature published in English between January 2010 and August 2021.
This search resulted in 2080 publications and 14 reports, with 137 peer-reviewed studies and 14 non-peer reviewed reports that met the inclusion criteria, yielding a total of 151 studies for the final review. There were similar findings among studies that compared the performances of assay manufacturers and sample types. Studies that evaluated various assay algorithms and thresholds were heterogeneous, illustrating the need for context-specific test characteristics for classifying recent infections. Most studies estimated subtype-specific test characteristics for HIV subtypes A, B, C, and D. This was further illustrated when looking only at studies that compared HIV incidence estimates from recency assay algorithms and longitudinal cohorts.
These findings suggest that the current body of knowledge provides important information that contributes towards distinguishing recent and non-recent infection and incidence estimation. However, there are knowledge gaps with respect to factors that influence the test characteristics (e.g., HIV-1 subtype, population characteristics, assay algorithms and thresholds). Further studies are needed to estimate and establish context-specific test characteristics that consider these influencing factors to improve and expand the use of this assay for detection of recent HIV infection.
检测新的和近期感染的艾滋病毒对于监测和评估控制疫情的干预措施至关重要。艾滋病毒近期感染检测方法是通过确定近期感染与非近期感染来提供可靠发病率估计的一种方式。本研究的目的是通过评估已知内容和差距，回顾关于有限抗原亲和力酶免疫测定法的现有知识体系，以扩大其支持的应用范围。
使用检索词“人类免疫缺陷病毒与亲和力”在PubMed、Embase和科学引文索引核心合集数据库中检索同行评审文献。还纳入了基于人群的艾滋病毒影响评估项目的非同行评审发表报告。这些文献限于2010年1月至2021年8月期间以英文发表的文献。
该检索共得到2080篇出版物和14份报告，其中137项同行评审研究和14份非同行评审报告符合纳入标准，最终纳入综述的研究共有151项。在比较检测方法制造商和样本类型性能的研究中发现了类似结果。评估各种检测算法和阈值的研究结果存在异质性，这表明需要针对特定情况的检测特征来分类近期感染。大多数研究估计了艾滋病毒A、B、C和D亚型的亚型特异性检测特征。当仅查看比较近期感染检测算法和纵向队列得出的艾滋病毒发病率估计的研究时，这一点得到了进一步说明。
这些研究结果表明，现有知识体系提供了有助于区分近期和非近期感染以及发病率估计的重要信息。然而，在影响检测特征的因素（如HIV-1亚型、人群特征、检测算法和阈值）方面存在知识空白。需要进一步研究来估计和确定考虑这些影响因素的特定情况检测特征，以改进和扩大该检测方法在检测近期艾滋病毒感染中的应用。
