Osong Public Health and Research Perspectives

Original Articles

Modification of AxSYM Human Immunodeficiency Virus Assay to Identify Recent Human Immunodeficiency Virus Infections in Korean Human Immunodeficiency Virus-Positive Individuals: Jin-Sook Wang, Mee-Kyung Kee, Byeong-Sun Choi, Sung Soon Kim; Osong Public Health Res Perspect. 2015;6(3):184-191. Published online June 30, 2015; DOI: https://doi.org/10.1016/j.phrp.2015.06.002

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Objectives
To estimate human immunodeficiency virus (HIV) incidence using HIV avidity assays in Korea, we established a serological testing method to differentiate recent HIV infections from long-standing ones.
Methods
We adopted two incidence assays, the BED HIV-1 incidence test (Calypte Biomedical) and an HIV avidity assay (using Abbott AxSYM HIV Antigen/Antibody Combo), and performed them on Korean HIV samples obtained from 81 HIV seroconverters (n = 193), 135 HIV-positive samples, and three HIV commercial incidence panels (PRB965, PRB933, and PRB601 from SeaCare). To determine the most optimal concentration of the chaotropic agent (Guanidine) and the cutoff value for the avidity assay, we evaluated the sensitivity and specificity of the assay at different concentration levels.
Results
We determined that the concentration of Guanidine to be used in the avidity assay was 1.5M. The cutoff value of the avidity index (AI) was 0.8, and the sensitivity and specificity were 90.2% and 83.8%, respectively, under this condition. The gray zone for the avidity assay was 0.75–0.85 AI. The mean of coefficient of variation was low, at 5.43%.
Conclusion
An optimized avidity assay for the diagnosis of recent HIV infections using Korean samples was established. This assay will be applied to investigate the level of recent infection and will provide basic data to the HIV prevention policy in Korea.

Citations

Citations to this article as recorded by

Characteristics of recent HIV infection among individuals newly diagnosed as HIV-positive in South Korea (2008–2015)
Myeongsu Yoo, Jin-Sook Wang, Su-Jin Park, Jeong-ok Cha, Yoonhee Jung, Yoon-Seok Chung, Myung Guk Han, Byeong-Sun Choi, Sung-Soon Kim, Mee-Kyung Kee
Scientific Reports.2022;[Epub] CrossRef

The Recency Period for Estimation of Human Immunodeficiency Virus Incidence by the AxSYM Avidity Assay and BED-Capture Enzyme Immunoassay in the Republic of Korea: Hye-Kyung Yu, Tae-Young Heo, Na-Young Kim, Jin-Sook Wang, Jae-Kyeong Lee, Sung Soon Kim, Mee-Kyung Kee; Osong Public Health Res Perspect. 2014;5(4):187-192. Published online August 31, 2014; DOI: https://doi.org/10.1016/j.phrp.2014.06.002

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Abstract PDF

Objectives
Measurement of the incidence of the human immunodeficiency virus (HIV) is very important for epidemiological studies. Here, we determined the recency period with the AxSYM avidity assay and the BED-capture enzyme immunoassay (BED-CEIA) in Korean seroconverters.
Methods
Two hundred longitudinal specimens from 81 seroconverters with incident HIV infections that had been collected at the Korea National Institute of Health were subjected to the AxSYM avidity assay (cutoff = 0.8) and BED-CEIA (cutoff = 0.8). The statistical method used to estimate the recency period in recent HIV infections was nonparametric survival analyses. Sensitivity and specificity were calculated for 10-day increments from 120 days to 230 days to determine the recency period.
Results
The mean recency period of the avidity assay and BED-CEIA using a survival method was 158 days [95% confidence interval (CI), 135–181 days] and 189 days (95% CI, 170–208 days), respectively. Based on the use of sensitivity and specificity, the mean recency period for the avidity assay and BED-CEIA was 150 days and 200 days, respectively.
Conclusion
We determined the recency period to estimate HIV incidence in Korea. These data showed that the nonparametric survival analysis often led to shorter recency periods than analysis of sensitivity and specificity as a new method. These findings suggest that more data from seroconverters and other methodologies are needed to determine the recency period for estimating HIV incidence.

Citations

Citations to this article as recorded by

Western Blot-Based Logistic Regression Model for the Identification of Recent HIV-1 Infection: A Promising HIV-1 Surveillance Approach for Resource-Limited Regions
Jiegang Huang, Minlian Wang, Chunyuan Huang, Bingyu Liang, Junjun Jiang, Chuanyi Ning, Ning Zang, Hui Chen, Jie Liu, Rongfeng Chen, Yanyan Liao, Li Ye, Hao Liang
BioMed Research International.2018; 2018: 1. CrossRef

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