Application Evaluation Of ML-PA Method For Detecting HIV-1 Recent Infection

Objective:Through a large number of HIV-1 positive samples,the consistency of the newly infected proportion and the trend of new infection rate of ML-PA method and BED-CEIA method were compared.The new infection rate and its changing trend in different years were estimated by the results of ML-PA detection of HIV-1 positive specimens in two places at different times.To provide scientific basis for the evaluation of local AIDS prevention and control effect and the formulation of prevention and control strategy.Methods:1.A sample of 2,766 HIV-1 infected individuals in 14 prefecture-level regions of Yunnan province was tested with the ML-PA method.The results of HIV-1 new infection detected by the ML-PA method were compared with those obtained by BED method.2.The newly infected HIV-1 positive samples of Lincang city from 2013 to 2017 were tested with ML-PA method,and the new infection rate trend and new infection rate were estimated in the sample.3.The newly infected HIV-1 positive samples of Zhaotong city zhaoyang district from 2016 to 2017 were tested with ML-PA method,to estimate the two key indicators of HIV-1 infection rate and new infection rate,analyze the characteristics of HIV epidemic in zhaoyang district.Results:1.Of the 2,766 samples,the ML-PA method was found to be 386 newly infected samples,with a recent infection rate of 13.96%;BED method found 518 newly infected,with a newly infected ratio of 18.73%;The concordant rate of the newly infected BED method was 50.19%;The concordant rate of ml-pa method for BED method was 94.40%.The Kappa value is 0.494rrr,and the two methods are of moderate consistency.2.The proportion of new infections detected by BED method for HIV-1 positive samples in Lincang city,Yunnan province from 2011 to 2013 was respectively:11.04%,15.07%,15.75%,the new infection rate is:0.026%(95%CI:0.021%～0.030%),0.067%(95%CI:0.056%～0.078%),0.025%(95%CI:0.020%～0.030%).The proportion of new infections detected by ML-PA method for HIV-1 positive samples in Lincang city,Yunnan province from 2013 to 2015 was respectively:3.83%、2.83%、4.46%、5.58%、4.47%,the new infection rate is:0.025%(95%CI:0.017%～0.033%)、0.014%(95%CI:0.009%～0.019%)、0.009%(95%CI:0.005%～0.013%)、0.009%(95%CI:0.06%～0.012%)、0.005%(95%CI:0.003%～0.007%).3.A new report of 338 HIV-1 infected patients in Zhaoyang district,Zhaotong city,Yunnan province from 2016 to 2017,detected 46 newly infected patients by ml-pa method,among them,transsexual transmission accounted for 89.1%.The sample source approach was mainly measured by the detection of consultation and other patients(88.0)%,There was no statistically significant difference between the sex,age and culture of HIV-1 in 2016-2017(P<0.05),but the difference in contact was statistically significant(P<0.05).4.A new report of HIV-1 infected patients in Zhaoyang district,Zhaotong city,Yunnan province from 2016 to 2017,the proportion of recent infections detected by the ML-PA method was successively 16.5%(30/182)、10.3%(16/156),the new infection rate is 0.017%(95%CI:0.017%～0.018%)、0.009%(95%CI:0.004%～0.018%).5.After the deletion of the AIDS patients and CD4+T cell count<200(cell/mm3)in the newly infected samples,the proportion of HIV-1 new infections decreased from 16.5%to 13.6%in 2016,and the proportion of HIV-1 newly infected decreased from 10.3%to 8.3%in 2017.Conclusions:1.The two experimental methods of ML-PA and BED were relatively low in differentiating between HIV-1 newly infected patients,and high consistency in differentiating HIV-1 long-term infection.2.The number of newly infected samples determined by ML-PA method is less than BED method.it may be related to the BED method for the miscarriage of long-term infection.3.The new report on HIV/AIDS in Zhaoyang district in 2016-2017 shows a high incidence of new HIV/AIDS infections and a high incidence of new infections,but the epidemic is declining.We should further expand the coverage of HIV surveillance and detection combining the characteristics of HIV/AIDS epidemic in Zhaoyang district,and take active and effective targeted interventions to key populations.4.The ML-PA method is also affected by the number of CD4+T cells and the samples of AIDS patients.A sample of AIDS and CD4+T cell count<200(cell/mm3)should be deleted to ensure the reliability and accuracy of HIV-1 new infection rate estimation when the ML-PA method was used to detect HIV-1 newly infected.