BED estimates of HIV incidence : resolving the differences, making things simpler
Date
2012-01
Authors
Hargrove, J.
Van Schalkwyk, C.
Eastwood, H.
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS
Abstract
Objective: Develop a simple method for optimal estimation of HIV incidence using the BED capture enzyme immunoassay.
Design: Use existing BED data to estimate mean recency duration, false recency rates and HIV incidence with reference to a
fixed time period, T.
Methods: Compare BED and cohort estimates of incidence referring to identical time frames. Generalize this approach to
suggest a method for estimating HIV incidence from any cross-sectional survey.
Results: Follow-up and BED analyses of the same, initially HIV negative, cases followed over the same set time period T,
produce estimates of the same HIV incidence, permitting the estimation of the BED mean recency period for cases who
have been HIV positive for less than T. Follow-up of HIV positive cases over T, similarly, provides estimates of the false-recent
rate appropriate for T. Knowledge of these two parameters for a given population allows the estimation of HIV incidence
during T by applying the BED method to samples from cross-sectional surveys. An algorithm is derived for providing these
estimates, adjusted for the false-recent rate. The resulting estimator is identical to one derived independently using a more
formal mathematical analysis. Adjustments improve the accuracy of HIV incidence estimates. Negative incidence estimates
result from the use of inappropriate estimates of the false-recent rate and/or from sampling error, not from any error in the
adjustment procedure.
Conclusions: Referring all estimates of mean recency periods, false-recent rates and incidence estimates to a fixed period T
simplifies estimation procedures and allows the development of a consistent method for producing adjusted estimates of
HIV incidence of improved accuracy. Unadjusted BED estimates of incidence, based on life-time recency periods, would be
both extremely difficult to produce and of doubtful value.
Description
The orginal version can be found on www.plos.org
Keywords
BED assay, Immunoassay, HIV infections
Citation
Hargrove, J., Van Schalkwyk, C., Eastwood H. 2012. BED estimates of HIV incidence: resolving the differences, making things simpler. PLoS ONE 7(1): e29736.