CEPHIA Publishes analysis of critical role of viral load testing to reduce false recent results obtained with current generation of Recent (HIV) Infection Testing Algorithms.

CEPHIA has published in AIDS an extensive analysis indicating that all the current front running serological assays proposed for recent infection detection are  sufficiently confounded by viral suppression (which tends to make long established infection appear to be recently acquired) for them to be unviable as stand-alone tests. However, as viral suppression is overwhelmingly the key predictor of false recent results, adding a viral load measurement to the recent infection testing algorithm (RITA) and adding “VL > some Threshold” to the case definition for “recent infection” is shown to produce a balance of Mean Duration of Recent Infection (MDRI) and False Recent Rate (FRR) which is compatible with meaningful surveillance applications, at least in contexts where incidence is high, and ambitious sample sizes are feasible.

Viral load criteria and threshold optimization to improve HIV incidence assay characteristics, Kassanjee, Reshma; Pilcher, Christopher D.; Busch, Michael P.; Murphy, Gary; Facente, Shelley N.; Keating, Sheila M.; Mckinney, Elaine; Marson, Kara; Price, Matthew A.; Martin, Jeffrey N.; Little, Susan J.; Hecht, Frederick M.; Kallas, Esper G.; Welte, Alex; on behalf of the Consortium for the Evaluation and Performance of HIV Incidence Assays (CEPHIA), AIDS 30(15), 2361-2371.