Trudy Dobbs

• Centers for Disease Control and Prevention

Background Sub-Saharan Africa region bears the highest chronic hepatitis B virus (HBV) infection burden worldwide. National estimates of HBV burden are necessary for a viral hepatitis program planning. This study estimated the national prevalence of HBV infection in Kenya among people aged 15–64 years. Methods Of 27,745 participants age 15–64 year...

The Sedia Biosciences Asanté rapid test for recent infection (RTRI) can identify HIV infections and characterize HIV-1 as recent or long-term infection via the positive verification (V) line and long-term line (LT) line, respectively. Tracking with Recency Assays to Control the Epidemic (TRACE) program uses RTRI assays. Successful implementation of...

Background Tuberculosis remains the leading cause of death by an infectious disease among people living with HIV (PLHIV). TB Preventive Treatment (TPT) is a cost-effective intervention known to reduce morbidity and mortality. We used data from ZIMPHIA 2020 to assess TPT uptake and factors associated with its use. Methodology ZIMPHIA a cross-sectio...

[This corrects the article DOI: 10.1371/journal.pgph.0000316.].

Background: In 2014, UNAIDS set the goal of ending the AIDS epidemic by 2030 through the achievement of testing and treatment cascade targets. To evaluate progress achieved and highlight persisting gaps in HIV epidemic control in Malawi, we aimed to compare key indicators (prevalence, incidence, viral load suppression, and UNAIDS 95-95-95 targets)...

We analyzed data from the 2018 Kenya Population-Based HIV Impact Assessment (KENPHIA), a cross-sectional, nationally representative survey, to estimate the burden and prevalence of pediatric HIV infection, identify associated factors, and describe the clinical cascade among children aged < 15 years in Kenya. Interviewers collected information from...

Background: Nationally-representative surveys provide an opportunity to assess trends in recent HIV infection based on assays for recent HIV infection. Methods: We assessed HIV incidence in Kenya in 2018 and trends in recent HIV infection among adolescents and adults in Kenya using nationally representative household surveys conducted in 2007, 2...

Objectives: In Malawi, a recent infection testing algorithm (RITA) is used to characterise infections of persons newly diagnosed with HIV as recent or long term. This paper shares results from recent HIV infection surveillance and describes distribution and predictors. Setting: Data from 155 health facilities in 11 districts in Malawi were poole...

Background Malawi spearheaded the development and implementation of Option B+ for prevention of mother-to-child transmission of HIV (PMTCT), providing life-long ART for all HIV-positive pregnant and breastfeeding women. We used data from the 2015–2016 Malawi Population-based HIV Impact Assessment (MPHIA) to estimate progress toward 90-90-90 targets...

Despite extensive global efforts, sub-Saharan Africa remains disproportionately affected by the HIV epidemic. This generalized epidemic can be seen in Lesotho which in 2014 the HIV prevalence rate of those aged 15–49 years was 24.6%, with and incidence of 1.9 new infections per 100-person-year exposures. To better understand the impact of Lesotho’s...

Following publication of the original article [1], the authors identified an error in the affiliations stated for the last author, Salem Gugsa. At the time of the manuscript development, the author’s affiliation was assigned to 3 instead of 4. The affiliations assignment is corrected in the author list of this Correction article and the original ar...

We previously described development of a rapid test for recent infection (RTRI) that can diagnose HIV infection and detect HIV-1 recent infections in a single device. This technology was transferred to a commercial partner as Asante Rapid Recency Assay (ARRA). We evaluated performance of the ARRA kits in the laboratory using a well-characterized pa...

Background The Malawi Ministry of Health implemented a new surveillance activity in April 2019 to detect recent HIV infections using a rapid test for recent infection (RTRI) to identify areas of ongoing transmission and guide response activities. Setting At 23 health facilities in Blantyre District, healthcare workers (HCWs) were trained to conduc...

Persons infected with HIV are more likely to transmit the virus during the early stages (acute and recent) of infection, when viral load is elevated and opportunities to implement risk reduction are limited because persons are typically unaware of their status (1,2). Identifying recent HIV infections (acquired within the preceding 12 months)* is cr...

Tests for recent HIV infection (TRI) distinguish recent from long-term HIV infections using markers of antibody maturation. The limiting antigen avidity enzyme immunoassay (LAg EIA) is widely used with HIV viral load (VL) in a recent infection testing algorithm (RITA) to improve classification of recent infection status, estimate population-level H...

With the highest HIV incidence and prevalence globally, the government of Eswatini started a substantial scale-up of HIV treatment and prevention services in 2011. Two sequential large population-based surveys were conducted before and after service expansion to assess the impact of the national response. Cross-sectional, household-based, nationall...

Background: HIV-1 incidence calculation currently includes recency classification by HIV-1 incidence assay and unsuppressed viral load (VL ≥ 1000 copies/mL) in a recent infection testing algorithm (RITA). However, persons with recent classification not virally suppressed and taking antiretroviral (ARV) medication may be misclassified. Setting: W...

Background: Zimbabwe conducted a Population-Based HIV Impact Assessment (ZIMPHIA) cross-sectional survey, October 2015 and August 2016 to determine progress toward epidemic control. Methods: Of 25,131 eligible adults 15-64 years, 20,577 (81.8%) consented to face-to-face questionnaire and biomarker testing in this nationally representative househ...

Reliable and accurate laboratory assays to detect recent HIV-1 infection have potential as simple and practical methods of estimating HIV-1 incidence in cross-sectional surveys. This study describes validation of the limiting-antigen (LAg) avidity enzyme immunoassay (EIA) in a cross-sectional national survey, conducted in Swaziland, comparing it to...

Biomarkers for detecting early HIV infection and estimating HIV incidence should minimize false-recent rates (FRRs) while maximizing mean duration of recent infection (MDRI). We compared HIV subtypes B, E and D (BED) capture enzyme immunoassay (BED), Sedia limiting antigen (LAg) avidity enzyme immunoassay, and Bio-Rad avidity incidence (BRAI) assay...

Background: Laboratory assays that identify recent HIV infections are important for assessing impacts of interventions aimed at reducing HIV incidence. Kinetics of HIV humoral responses can vary with inherent assay properties, and between HIV subtypes, populations and physiological states. They are important in determining mean duration of recent...

Background: Laboratory tests that can distinguish recent from long-term HIV infection are used to estimate HIV incidence in a population but can potentially misclassify a proportion of long-term HIV infections as recent. Correct application of an assay requires determination of the proportion false recents (PFR) as part of the assay characterizati...

Introduction A recent infection testing algorithm (RITA) that can distinguish recent from long-standing HIV infection can be applied to nationally representative population-based surveys to characterize and identify risk factors for recent infection in a country. Materials and Methods We applied a RITA using the Limiting Antigen Avidity Enzyme Imm...

KAIS Analysis and Publication Concept Sheet Template. (DOCX)

HIV incidence estimates are used to monitor HIV-1 infection in the United States. Use of laboratory biomarkers that distinguish recent from longstanding infection to quantify HIV incidence rely on having accurate knowledge of the average time that individuals spend in a transient state of recent infection between seroconversion and reaching a speci...

Spreadsheet with BED OD values at times since estimated time of seroconversion, assayed for 858 specimens from 209 HIV-1 subtype B seroconverters, taken from 4 data cohorts. (XLSX)

Spreadsheet with Bio-Rad avidity values at times since estimated time of seroconversion, assayed for 749 specimens from 162 HIV-1 subtype B seroconverters, taken from 3 data cohorts. (XLSX)

Mean duration of recent infection (MDRI) and misclassification of long-term HIV-1 infections, as proportion false recent (PFR), are critical parameters for laboratory-based assays for estimating HIV-1 incidence. Recent review of the data by us and others indicated that MDRI of LAg-Avidity EIA estimated previously required recalibration. We present...

BACKGROUND: Accurate and reliable laboratory methods are needed for estimation of HIV-1 incidence to identify the high-risk populations and target and monitor prevention efforts. We previously described a single-well limiting-antigen avidity enzyme immunoassay (LAg-Avidity EIA) to detect recent HIV-1 infection. METHODS: We describe here further opt...

Effect of Days at 25°C on BED-CEIA Assay Results. Samples from subtype C infected individuals from South Africa are marked in green. Samples from subtype A infected individuals from Uganda are marked in orange. Samples from subtype D infected individuals from Uganda are marked in red. Samples from subtype B infected individuals are marked in blue....

Effect of Days at 4°C on Vironostika-LS Assay Results. Samples from subtype C infected individuals from South Africa are marked in green. Samples from subtype A infected individuals from Uganda are marked in orange. Samples from subtype D infected individuals from Uganda are marked in red. Samples from subtype B infected individuals are marked in b...

Effect of Days at 4°C on Avidity Assay Results. Samples from subtype C infected individuals from South Africa are marked in green. Samples from subtype A infected individuals from Uganda are marked in orange. Samples from subtype D infected individuals from Uganda are marked in red. Samples from subtype B infected individuals are marked in blue. Th...

Effect of Days at 37°C on Avidity Assay Results. Samples from subtype C infected individuals from South Africa are marked in green. Samples from subtype A infected individuals from Uganda are marked in orange. Samples from subtype D infected individuals from Uganda are marked in red. Samples from subtype B infected individuals are marked in blue. T...

Effect of Freeze Thaw Cycles on Avidity Assay Results. Samples from subtype C infected individuals from South Africa are marked in green. Samples from subtype A infected individuals from Uganda are marked in orange. Samples from subtype D infected individuals from Uganda are marked in red. Samples from subtype B infected individuals are marked in b...

Effect of Days at 37°C on BED-CEIA Assay Results. Samples from subtype C infected individuals from South Africa are marked in green. Samples from subtype A infected individuals from Uganda are marked in orange. Samples from subtype D infected individuals from Uganda are marked in red. Samples from subtype B infected individuals are marked in blue....

Freeze Thaw Cycles on BED-CEIA Assay Results. Samples from subtype C infected individuals from South Africa are marked in green. Samples from subtype A infected individuals from Uganda are marked in orange. Samples from subtype D infected individuals from Uganda are marked in red. Samples from subtype B infected individuals are marked in blue. The...

Freeze Thaw Cycles on Vironostika-LS Assay Results. Samples from subtype C infected individuals from South Africa are marked in green. Samples from subtype A infected individuals from Uganda are marked in orange. Samples from subtype D infected individuals from Uganda are marked in red. Samples from subtype B infected individuals are marked in blue...

Effect of Days at 4°C on BED-CEIA Assay Results. Samples from subtype C infected individuals from South Africa are marked in green. Samples from subtype A infected individuals from Uganda are marked in orange. Samples from subtype D infected individuals from Uganda are marked in red. Samples from subtype B infected individuals are marked in blue. T...

Effect of Time at 25°C on Vironostika-LS Assay Results. Samples from subtype C infected individuals from South Africa are marked in green. Samples from subtype A infected individuals from Uganda are marked in orange. Samples from subtype D infected individuals from Uganda are marked in red. Samples from subtype B infected individuals are marked in...

Effect of Days at 37°C on Vironostika -LS Assay. Samples from subtype C infected individuals from South Africa are marked in green. Samples from subtype A infected individuals from Uganda are marked in orange. Samples from subtype D infected individuals from Uganda are marked in red. Samples from subtype B infected individuals are marked in blue. T...

Effect of Days at 25°C on Avidity Assay Results. Samples from subtype C infected individuals from South Africa are marked in green. Samples from subtype A infected individuals from Uganda are marked in orange. Samples from subtype D infected individuals from Uganda are marked in red. Samples from subtype B infected individuals are marked in blue. T...

To determine if mishandling prior to testing would make a sample from a chronically infected subject appear recently infected when tested by cross-sectional HIV incidence assays. Serum samples from 31 subjects with chronic HIV infection were tested. Samples were subjected to different handling conditions, including incubation at 4 °C, 25 °C and 37...

The HIV-1 BED incidence assay was developed at the Centers for Disease Control and Prevention and since 2005 has been available as a commercial kit for use in HIV-1 incidence surveillance. A BED-specific proficiency testing (PT) program was initiated in 2006 that included a panel of eight coded specimens (six unique and two duplicates) to participa...

Transmitted drug resistance (TDR) reduces the efficacy of antiretroviral treatment and is a public health concern. To gain insight in the epidemiology of TDR in Honduras by evaluating the amount of TDR in a representative sample of newly diagnosed individuals and by determining whether these are recent or established infections. Two hundred treatme...

The IgG capture BED enzyme immunoassay (BED-CEIA) was developed to detect recent HIV-1 infection for the estimation of HIV-1 incidence from cross-sectional specimens. The mean time interval between seroconversion and reaching a specified assay cutoff value [referred to here as the mean recency period (ω)], an important parameter for incidence estim...

Current laboratory methods to detect recent HIV-1 infection for the estimation of incidence have various limitations, including varying performance in different subtypes or populations. Therefore, new methods are needed to detect recent infections with increased specificity. We developed a recombinant protein, rIDR-M, that covered divergent sequenc...

The BED capture enzyme immunoassay (BED CEIA) for recent infection was developed for the estimation of HIV-1 incidence in a population from a single cross-sectional survey. To evaluate performance, we applied the assay to specimen sets obtained from a longitudinal cohort study, the AIDSVAX B/B vaccine trial, in which there was an independent and co...

This study reports trends in HIV-1 incidence in Cambodia among different target groups in the HIV-1 Sentinel Surveillance Program in 1999, 2000, and 2002, using the newly developed IgG capture BED-enzyme (HIV subtypes B, E and D) immunoassay (BED-CEIA). HIV-1-positive specimens (n=3599) from 4 sentinel groups in the HIV-1 Sentinel Surveillance Prog...

Recently, we developed an immunoglobulin G (IgG)-capture BED-enzyme immunoassay (BED-CEIA) to identify recent HIV-1 infections. We estimated HIV-1 incidence among inner-city pregnant women in Atlanta, Georgia (1991-1998) using this assay. The annual cumulative incidence was estimated at 2.4/1000 (95% CI = 2.0-2.9). Incidence declined from 3.1/1000...

Recently, we developed an immunoglobulin G (IgG)-capture BED-enzyme immunoassay (BED-CEIA) to identify recent human immunodeficiency virus (HIV) type 1 (HIV-1) seroconversion for use in incidence estimates. We have established an algorithm for its use; developed quality control reagents to monitor the assay; and evaluated its performance for interr...

To estimate the prevalence of HIV strains other than the predominant HIV-1B subtype in the U.S. blood donor population we genetically and serologically characterized HIV in infected blood donations collected throughout he United States from 1997 to mid-2000. Using a combination of DNA heteroduplex mobility and DNA sequence analyses of the env and g...

Development of serologic tests to detect recent HIV-1 infection has generated worldwide interest in applying this approach to estimate incidence. We previously devised an IgG-capture BED-EIA (or BED-CEIA) that detects increasing levels of anti-HIV IgG following seroconversion to identify recent infection and to estimate incidence among persons infe...

We have devised a simple enzyme immunoassay (EIA) that detects increasing levels of anti-HIV IgG after seroconversion and can be used for detecting recent HIV-1 infection. Use of a branched peptide that included gp41 immunodominant sequences from HIV-1 subtypes B, E, and D allowed similar detection of HIV-specific antibodies among various subtypes....

To assess the impact of antiretroviral resistance on perinatal transmission prevention efforts, human immunodeficiency virus type 1 (HIV-1) genotypic resistance testing was done for 220 HIV-1–infected, zidovudine (AZT)–exposed pregnant women and 24 of their infected infants. The women were prospectively enrolled in 4 US cities in 1991–1997. Phyloge...

We evaluated 16 antibody assays for their performance in discriminating recent from established HIV-1 infection. These approaches were based on antigen specificity, quantity, conformation dependence, and avidity/affinity of HIV-specific antibodies. A panel of 41 sera from subjects who had seroconverted in the previous 2-6 months (n = 20) and from s...

Limited data exist on the distribution of HIV-1 subtypes in Côte d'Ivoire. The aim of this study is to describe the distribution of genetic subtypes of HIV-1 strains in six regions of Côte d'Ivoire. In 1997, we consecutively collected blood from 172 HIV-1-infected patients from six regional tuberculosis treatment centers. Peripheral blood mononucle...

We modified and evaluated a RIA for serum and used the modified RIA to measure zidovudine in dried blood spot specimens (DBSs) routinely collected for newborn screening and tested anonymously for maternally acquired HIV antibodies in the national HIV Seroprevalence Survey Among Childbearing Women. DBS calibration and quality-control materials were...

To the Editor. —In August 1994, the US Public Health Service issued recommendations for administering zidovudine to pregnant women infected with the human immunodeficiency virus (HIV) and their newborns to reduce the risk of perinatal HIV transmission.1 We conducted an anonymous, population-based study to estimate the proportion of HIV-infected wo...