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Evaluation of multi-assay algorithms for identifying individuals with recent HIV infection: HPTN 071 (PopART)

Author

Listed:
  • Wendy Grant-McAuley
  • Ethan Klock
  • Oliver Laeyendecker
  • Estelle Piwowar-Manning
  • Ethan Wilson
  • William Clarke
  • Autumn Breaud
  • Ayana Moore
  • Helen Ayles
  • Barry Kosloff
  • Kwame Shanaube
  • Peter Bock
  • Nomtha Mandla
  • Anneen van Deventer
  • Sarah Fidler
  • Deborah Donnell
  • Richard Hayes
  • Susan H Eshleman
  • for the HPTN 071 (PopART) Study Team

Abstract

Background: Assays and multi-assay algorithms (MAAs) have been developed for population-level cross-sectional HIV incidence estimation. These algorithms use a combination of serologic and/or non-serologic biomarkers to assess the duration of infection. We evaluated the performance of four MAAs for individual-level recency assessments. Methods: Samples were obtained from 220 seroconverters (infected 1 year) enrolled in an HIV prevention trial (HPTN 071 [PopART]); 28.6% of the seroconverters and 73.4% of the non-seroconverters had HIV viral loads ≤400 copies/mL. Samples were tested with two laboratory-based assays (LAg-Avidity, JHU BioRad-Avidity) and a point-of-care assay (rapid LAg). The four MAAs included different combinations of these assays and HIV viral load. Seroconverters on antiretroviral treatment (ART) were identified using a qualitative multi-drug assay. Results: The MAAs identified between 54 and 100 (25% to 46%) of the seroconverters as recently-infected. The false recent rate of the MAAs for infections >2 years duration ranged from 0.2%-1.3%. The MAAs classified different overlapping groups of individuals as recent vs. non-recent. Only 32 (15%) of the 220 seroconverters were classified as recent by all four MAAs. Viral suppression impacted the performance of the two LAg-based assays. LAg-Avidity assay values were also lower for seroconverters who were virally suppressed on ART compared to those with natural viral suppression. Conclusions: The four MAAs evaluated varied in sensitivity and specificity for identifying persons infected

Suggested Citation

  • Wendy Grant-McAuley & Ethan Klock & Oliver Laeyendecker & Estelle Piwowar-Manning & Ethan Wilson & William Clarke & Autumn Breaud & Ayana Moore & Helen Ayles & Barry Kosloff & Kwame Shanaube & Peter B, 2021. "Evaluation of multi-assay algorithms for identifying individuals with recent HIV infection: HPTN 071 (PopART)," PLOS ONE, Public Library of Science, vol. 16(12), pages 1-14, December.
    • Handle: RePEc:plo:pone00:0258644
    DOI: 10.1371/journal.pone.0258644
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    References listed on IDEAS

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    1. Jacob Konikoff & Ron Brookmeyer & Andrew F Longosz & Matthew M Cousins & Connie Celum & Susan P Buchbinder & George R Seage III & Gregory D Kirk & Richard D Moore & Shruti H Mehta & Joseph B Margolick, 2013. "Performance of a Limiting-Antigen Avidity Enzyme Immunoassay for Cross-Sectional Estimation of HIV Incidence in the United States," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-9, December.
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