Estimation of the Distribution of Infection Times Using Longitudinal Serological Markers of HIV: Implications for the Estimation of HIV Incidence
Version of Record online: 23 AUG 2010
© 2010, The International Biometric Society
Volume 67, Issue 2, pages 467–475, June 2011
How to Cite
Sommen, C., Commenges, D., Vu, S. L., Meyer, L. and Alioum, A. (2011), Estimation of the Distribution of Infection Times Using Longitudinal Serological Markers of HIV: Implications for the Estimation of HIV Incidence. Biometrics, 67: 467–475. doi: 10.1111/j.1541-0420.2010.01473.x
- Issue online: 20 JUN 2011
- Version of Record online: 23 AUG 2010
- Received September 2009. Revised May 2010. Accepted May 2010.
- HIV incidence;
- Longitudinal data;
- Mixed model;
- Recent infections;
- Surveillance system
Summary In the last decade, interest has been focused on human immunodeficiency virus (HIV) antibody assays and testing strategies that could distinguish recent infections from established infection in a single serum sample. Incidence estimates are obtained by using the relationship between prevalence, incidence, and duration of recent infection (window period). However, recent works demonstrated limitations of this approach due to the use of an estimated mean “window period.” We propose an alternative approach that consists in estimating the distribution of infection times based on serological marker values at the moment when the infection is first discovered. We propose a model based on the repeated measurements of virological markers of seroconversion for the marker trajectory. The parameters of the model are estimated using data from a cohort of HIV-infected patients enrolled during primary infection. This model can be used for estimating the distribution of infection times for newly HIV diagnosed subjects reported in a HIV surveillance system. An approach is proposed for estimating HIV incidence from these results.