Background: Timely detection of recent HIV infections is critical in achieving the HIV epidemic. The aim of this study was to evaluate the effects of integrating the Recent Infection Testing Algorithm in HIV surveilla...Background: Timely detection of recent HIV infections is critical in achieving the HIV epidemic. The aim of this study was to evaluate the effects of integrating the Recent Infection Testing Algorithm in HIV surveillance in Ekiti State, South West Nigeria. Method: Data from the Nigeria Medical Records System (NMRS)/National Data Repository (NDR) and Index Testing (IT) Services data capturing tools were abstracted for a retrospective cross-sectional study of 719 newly diagnosed HIV-positive cases who were screened for HIV incident infection using Asante rapid recency test kits between August 2020 and June 2022 at 5 selected recency testing health facilities. The venous blood (10 ml) of all the rapid Asante tested recent patients were collected into an EDTA tube and processed for viral load testing. The plasma level of HIV-1 RNA was quantified using the CAP/CTM and cobas 4800 platform at Obafemi Awolowo University Teaching Hospital PCR Laboratory Ife. Chi-square was used to characterize the recency status of the patients. A measure of the association was done using Chi-square, while the p-value of 0.05 was considered statistically significant. Results: The median age of the participants was 39 years. The result from the study showed that of the total number of 719 new cases of diagnosed HIV-positive, 626 of them were screened for rapid Test for Recency infection (RTRI) (87%). Overall, we found that 1.8% (11/626) of clients were classified as recent. The investigation also showed that from the index cases of the 11 confirmed recent infections, a total number of 125 additional positive cases were found. Conclusion: This result indicated a rise in the number of cases discovered in the State. Therefore, incorporating recency testing within regular HIV testing programs becomes essential in order to prioritize clients for index testing and provide useful information on transmission clusters.展开更多
BACKGROUND Human immunodeficiency virus(HIV)recency testing provides data that can be used to monitor the trend of new HIV infections.The effectiveness of using people identified with recent infection to identify part...BACKGROUND Human immunodeficiency virus(HIV)recency testing provides data that can be used to monitor the trend of new HIV infections.The effectiveness of using people identified with recent infection to identify partners with new HIV infection through partner notification services(PNS)is not well documented.AIM To determine the pooled prevalence of recency testing coverage,recent infection,reclassification(recent to longterm infection)and PNS cascade among newly diagnosed people living with HIV.METHODS PubMed,Cochrane Library and Embase were searched for articles published between January 2018 and November 2024.Studies were included if they reported recency coverage and/or PNS among people newly diagnosed with HIV and used recent infection testing algorithm(RITA).Recency coverage was defined as proportion of people tested using rapid testing for recent infection(RTRI)among those newly diagnosed with HIV.RITA further classifies RTRI results using viral load results(≥1000 copies/mL vs<1000 copies/mL)to confirm recency status.For studies with PNS,we evaluated the cascade:Number of partners elicited,successfully contacted,eligible for HIV testing,tested and HIV diagnosis.PNS effectiveness was measured by proportion of new HIV diagnoses from tested partners.Using random effects models,we computed the pooled estimate of recency outcomes and 95%confidence intervals(CIs).RESULTS Twenty-five studies from 17-low-and middle-income countries were included.Of 276315 newly diagnosed people living with HIV,79864 underwent RTRI with an overall pooled recency coverage of 87%(95%CI:67-96).The pooled prevalence of RTRI and RITA recency were 12%(95%CI:9-16)and 7%(95%CI:4-10),respectively.Pooled prevalence of RTRI reclassification was 34%(95%CI:22-49).Of the recent cases who agreed to PNS,253 partners were elicited with an estimated elicitation ratio of 1:1.6.Among partners elicited,99%were successfully contacted,75%were eligible for testing,68%tested for HIV,and 15%were diagnosed with HIV.CONCLUSION High recency testing coverage among newly diagnosed individuals demonstrates the feasibility of monitoring new HIV infections in LMIC.While PNS yielded moderate HIV diagnoses,its targeted approach remains a critical strategy for identifying undiagnosed cases.展开更多
文摘Background: Timely detection of recent HIV infections is critical in achieving the HIV epidemic. The aim of this study was to evaluate the effects of integrating the Recent Infection Testing Algorithm in HIV surveillance in Ekiti State, South West Nigeria. Method: Data from the Nigeria Medical Records System (NMRS)/National Data Repository (NDR) and Index Testing (IT) Services data capturing tools were abstracted for a retrospective cross-sectional study of 719 newly diagnosed HIV-positive cases who were screened for HIV incident infection using Asante rapid recency test kits between August 2020 and June 2022 at 5 selected recency testing health facilities. The venous blood (10 ml) of all the rapid Asante tested recent patients were collected into an EDTA tube and processed for viral load testing. The plasma level of HIV-1 RNA was quantified using the CAP/CTM and cobas 4800 platform at Obafemi Awolowo University Teaching Hospital PCR Laboratory Ife. Chi-square was used to characterize the recency status of the patients. A measure of the association was done using Chi-square, while the p-value of 0.05 was considered statistically significant. Results: The median age of the participants was 39 years. The result from the study showed that of the total number of 719 new cases of diagnosed HIV-positive, 626 of them were screened for rapid Test for Recency infection (RTRI) (87%). Overall, we found that 1.8% (11/626) of clients were classified as recent. The investigation also showed that from the index cases of the 11 confirmed recent infections, a total number of 125 additional positive cases were found. Conclusion: This result indicated a rise in the number of cases discovered in the State. Therefore, incorporating recency testing within regular HIV testing programs becomes essential in order to prioritize clients for index testing and provide useful information on transmission clusters.
文摘BACKGROUND Human immunodeficiency virus(HIV)recency testing provides data that can be used to monitor the trend of new HIV infections.The effectiveness of using people identified with recent infection to identify partners with new HIV infection through partner notification services(PNS)is not well documented.AIM To determine the pooled prevalence of recency testing coverage,recent infection,reclassification(recent to longterm infection)and PNS cascade among newly diagnosed people living with HIV.METHODS PubMed,Cochrane Library and Embase were searched for articles published between January 2018 and November 2024.Studies were included if they reported recency coverage and/or PNS among people newly diagnosed with HIV and used recent infection testing algorithm(RITA).Recency coverage was defined as proportion of people tested using rapid testing for recent infection(RTRI)among those newly diagnosed with HIV.RITA further classifies RTRI results using viral load results(≥1000 copies/mL vs<1000 copies/mL)to confirm recency status.For studies with PNS,we evaluated the cascade:Number of partners elicited,successfully contacted,eligible for HIV testing,tested and HIV diagnosis.PNS effectiveness was measured by proportion of new HIV diagnoses from tested partners.Using random effects models,we computed the pooled estimate of recency outcomes and 95%confidence intervals(CIs).RESULTS Twenty-five studies from 17-low-and middle-income countries were included.Of 276315 newly diagnosed people living with HIV,79864 underwent RTRI with an overall pooled recency coverage of 87%(95%CI:67-96).The pooled prevalence of RTRI and RITA recency were 12%(95%CI:9-16)and 7%(95%CI:4-10),respectively.Pooled prevalence of RTRI reclassification was 34%(95%CI:22-49).Of the recent cases who agreed to PNS,253 partners were elicited with an estimated elicitation ratio of 1:1.6.Among partners elicited,99%were successfully contacted,75%were eligible for testing,68%tested for HIV,and 15%were diagnosed with HIV.CONCLUSION High recency testing coverage among newly diagnosed individuals demonstrates the feasibility of monitoring new HIV infections in LMIC.While PNS yielded moderate HIV diagnoses,its targeted approach remains a critical strategy for identifying undiagnosed cases.
