ABSTRACT
Between 1999 and 2000, new diagnoses of HIV in Victoria (Australia) rose by 41%, from 140 to 197. In this time period, sera from new HIV diagnoses were tested using the Organon Teknika "detuned" enzyme immunoassay (EIA). We compared the results of the detuned EIA with incident infections defined by surveillance (on the basis of a previous negative or indeterminate HIV test and/or a seroconversion illness within the 12 months preceding HIV diagnosis). Of 317 specimens, 97 (31%) incident infections and 114 (36%) recent infections were detected using surveillance and detuned EIA, respectively. The detuned assay misclassified 11 cases with AIDS and 2 cases with CD4 counts < or = 200 micro3 (probable long-standing infections) as recent infections and was unable to identify 31 (32%) of 97 cases previously classified as incident cases by surveillance. The assay detected an extra 35 recent infections that were previously classified as nonincident by surveillance. By combining the detuned assay and surveillance, 132 (42%) incident infections were identified from 317 specimens, 36% more than surveillance alone. We recommend that a detuned assay or similar test become part of the routine strategy to identify incident infections in Victoria. Incident infections provide important information for targeting prevention strategies and the opportunity to interrupt ongoing viral transmission.
Subject(s)
HIV Infections/epidemiology , Adolescent , Adult , Aged , Child , Female , HIV Infections/diagnosis , HIV Seropositivity/epidemiology , Humans , Immunoenzyme Techniques/standards , Incidence , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity , Victoria/epidemiologyABSTRACT
OBJECTIVES: To describe the epidemiology of HIV in Victoria between 1997 and 2002 using HIV surveillance data. METHODS: All HIV diagnoses notified to the Victorian HIV Registry from 1997 to 2002 were described. RESULTS: The average annual number of HIV notifications rose from 160 during 1997-99 to 216 during 2000-02, with the number of infections from men who have sex with men (MSM) increasing by 41%. Notifications from MSM acquired from casual or anonymous partners increased from 65 in 1997-99 to 92 in 2000-02. Infections attributable to heterosexual contact increased from an average number of 30 during 1997-99 to 46 during 2000-02, a 53% increase. CONCLUSIONS: This rise in HIV notifications in Victoria threatens this State's progress in controlling the HIV epidemic. IMPLICATIONS: The surveillance data demonstrate a need to implement effective, innovative and evidence-based programs for HIV prevention.
