Use of surveillance data on HIV diagnoses with HIV-related symptoms to estimate the number of people living with undiagnosed HIV in need of antiretroviral therapy

PloS One
Rebecca K LodwickAndrew N Phillips

Abstract

It is important to have methods available to estimate the number of people who have undiagnosed HIV and are in need of antiretroviral therapy (ART). The method uses the concept that a predictable level of occurrence of AIDS or other HIV-related clinical symptoms which lead to presentation for care, and hence diagnosis of HIV, arises in undiagnosed people with a given CD4 count. The method requires surveillance data on numbers of new HIV diagnoses with HIV-related symptoms, and the CD4 count at diagnosis. The CD4 count-specific rate at which HIV-related symptoms develop are estimated from cohort data. 95% confidence intervals can be constructed using a simple simulation method. For example, if there were 13 HIV diagnoses with HIV-related symptoms made in one year with CD4 count at diagnosis between 150-199 cells/mm3, then since the CD4 count-specific rate of HIV-related symptoms is estimated as 0.216 per person-year, the estimated number of person years lived in people with undiagnosed HIV with CD4 count 150-199 cells/mm3 is 13/0.216 = 60 (95% confidence interval: 29-100), which is considered an estimate of the number of people living with undiagnosed HIV in this CD4 count stratum. The method is straightforward to implement with...Continue Reading

References

Jan 26, 2002·BMJ : British Medical Journal·Dilys MorganJames A G Whitworth
Feb 8, 2002·BMJ : British Medical Journal·Peter H Kilmarx
Dec 2, 2005·Statistics in Medicine·Michael J SweetingOdd O Aalen
Aug 5, 2008·JAMA : the Journal of the American Medical Association·H Irene HallUNKNOWN HIV Incidence Surveillance Group
Jun 22, 2010·HIV Medicine·A AntinoriUNKNOWN European Late Presenter Consensus Working Group
Oct 12, 2010·Sexually Transmitted Infections·Tim BrownPatrick Gerland

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Citations

Mar 21, 2019·JMIR Public Health and Surveillance·Brian RiceJames Hargreaves
Aug 11, 2016·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Ruiguang SongNikos Pantazis
Aug 23, 2018·Revista Da Sociedade Brasileira De Medicina Tropical·Luis Lopes Sombra NetoLara Gurgel Fernandes Távora
Apr 19, 2018·Euro Surveillance : Bulletin Européen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin·Vincenza Regine The Regional Representatives Of The National Hiv Surveillance System

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