STARHSSerologic Testing Algorithm for Recent HIV Seroconversion
STARHSSerologic Testing Algorithm for Determining Recent HIV Seroconversion
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* STARHS is needed in addition to the direct viral test, because it picks up many more new infections, helping epidemiologists better understand where the epidemic is moving now.
* The public-health use of STARHS was delayed when Abbott Laboratories withdrew its test from the market.
Samples from 2007 had previously been evaluated by the STARHS method (Vironostika HIV-1 microElisa System; bioMerieux--Raleigh, NC, USA), while in the 2008 and 2009 samples, the LS-HIV Vitros Assay method (Ortho Diagnostics, Raritan, NJ) was utilized.
Statistical analysis was performed using the kappa coefficient, which assesses the agreement beyond chance of the results with the reference methods (STARHS and LS-HIV Vitros assay).
A total of 1,767 (78%) were men who had one of more male sex partners and agreed to the survey, HIV test, and STARHS test (range by city: 222-462).
We previously reported the estimated incidence of recent infections in men and in nonpregnant women using the STARHS algorithm [4,5].
HIV incidence was estimated by STARHS for men who had P&S syphilis diagnosed at SFCC in 2002 and 2003 and who accepted confidential HIV-antibody and STARHS testing.
Fourth, STARHS might misclassify a small percentage of persons with longstanding infection as recently infected and vice versa (9,10).
In the STARHS methodology, serum samples testing positive for HIV-1 in the initial ELISA are retested.
We used the STARHS methodology to calculate the number of recent HIV-1 infections in samples collected at HIV CT centers between November 2000 and April 2001.
Of the 249 HIV-positive specimens, 224 were tested by STARHS; 29 met the criteria for recent infection (Table 1).
This is the first published report using STARHS to provide incidence estimates in community-recruited sample surveys.