Detection of acute HIV infections in an urban HIV counseling and testing population in the United States.

摘要: The southeastern United States has an increasing burden of HIV, particularly among blacks, women, and men who have sex with men. To evaluate HIV nucleic acid amplification testing (NAAT) antibody-based algorithms in determination incidence, detection acute infections, surveillance drug-resistant virus transmission the urban States, we conducted a cross-sectional analysis prospectively collected data from 2202 adults receiving counseling at 3 sites Atlanta, GA October 2002 through January 2004. After standard enzyme immunoassay (EIA) Western blot confirmation, HIV-positive specimens were tested 2 standardized assays to detect recent infection. antibody-negative pooled screened for using NAAT. Seventy (3.2%) subjects infected. Only 66 positive on antibody test; 4 but acutely overall annual incidence was 1.1% (95% confidence interval [CI]: 0.4 1.8) based Vironostika-LS assay 1.3% CI: 0.6 2.1) BED Incidence Enzyme Immunoassay (EIA). prevalence infection 1.8 per 1000 persons 0.7 4.6). sensitivity current algorithm EIA test detectable infections only 94.3% 86.2 97.8). All infected genotyped had drug resistance mutations, 1 multiclass resistance. Adding NAAT-based screening increased case identification by 6% uncovered first evidence multidrug-resistant Atlanta. Antibody tests alone are insufficient public health practice high-risk settings.