Short Communication: False Recent Ratio of the Limiting-Antigen Avidity Assay and Viral Load Testing Algorithm Among Cameroonians with Long-Term HIV Infection

• Published in: AIDS research and human retroviruses Vol. 33; no. 11; p. 1114
• Main Authors: Lynch, Briana A, Patel, Eshan U, Courtney, Colleen R, Nanfack, Aubin J, Bimela, Jude, Wang, Xiaohong, Eid, Issa, Quinn, Thomas C, Laeyendecker, Oliver, Nyambi, Phillipe N, Duerr, Ralf, Redd, Andrew D
• Format: Journal Article
• Language: English
• Published: United States 01.11.2017
• Subjects: Adult; Aged; Cameroon - epidemiology; Cross-Sectional Studies; Diagnostic Errors; Diagnostic Tests, Routine - methods; Female; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - virology; Humans; Immunoassay - methods; Incidence; Male; Middle Aged; Viral Load - methods; HIV; cross-sectional incidence; Cameroon
• ISSN: 0889-2229; 1931-8405; 1931-8405
• DOI: 10.1089/AID.2017.0084

Current serological assays that are used for cross-sectional HIV incidence estimation have been shown to misclassify individuals with chronic infection. Limited information exists on the performance of cross-sectional incidence assays in Central Africa. HIV-positive individuals from Cameroon who were infected for at least 1 or 2 years were evaluated to determine the false recent ratio (FRR) of a two-assay algorithm, which includes the Limiting Antigen Avidity (LAg-Avidity) assay (normalized optical density units, ODn <1.5) and HIV viral load (>1000 copies/ml). The subject-level FRR was 5.3% (95% confidence interval [CI], 2.1-10.5) for individuals infected for ≥1 year and 3.9% (95% CI, 0.8-11.0) for individuals infected for ≥2 years. These data suggest that the LAg-Avidity plus viral load incidence algorithm may overestimate HIV incidence rates in Central Africa.