| Titre : | Direct and indirect estimates of HIV-1 incidence in a high-prevalence population. (1998) |
| Auteurs : | F.R. CLEGHORN ; C. BARTHOLOMEW ; W.A. BLATTNER ; R. BROOKMEYER ; J. EDWARDS ; M. GREENBERG ; N. JACK ; B. MAHABIR ; J.R. MURPHY ; T. O'BRIEN ; R. PAUL ; K. WEINHOLD ; Duke University Center for Aids Research. Raleigh Durham NC. USA ; The Caribbean Epidemiology Centre. Port of Spain. TTO ; The Ministry of Health. Government of Trinidad and Tobago. TTO ; The Viral Epidemiology Branch. Division of Cancer Etiology. National Cancer Institute. National Institutes of Health. Bethesda MD. USA |
| Type de document : | Article |
| Dans : | American journal of epidemiology (vol. 147, n° 9, 1998) |
| Pagination : | 834-839 |
| Langues: | Anglais |
| Mots-clés : | Sida ; Virose ; Infection ; VIH ; Rétrovirus ; Virus ; Epidémiologie ; Incidence ; Homme ; Etats Unis ; Amérique du Nord ; Amérique ; Trinidad & Tobago ; Antilles ; Amérique centrale ; Immunopathologie |
| Résumé : | [BDSP. Notice produite par INIST R0xt5Wyr. Diffusion soumise à autorisation]. While the worldwide AIDS epidemic continues to expand, directly measured incidence data are difficult to obtain. Methods to reliably estimate human immunodeficiency virus type 1 (HIV-1) incidence from more easily available data are particularly relevant in those parts of the world where prevalence is rising in heterosexually exposed populations. The authors set out to estimate HIV-1 incidence in a population of heterosexual sexually transmitted disease clinic attendees in Trinidad who had a known high prevalence of HIV-1 subtype B. Over the period 1987-1995, HIV-1 incidence estimates from serial cross-sectional studies of HIV-1 prevalence, passive follow-up of clinic recidivists, modeling of early markers of HIV-1 infection (p24 antigen screening), and a cohort study of seronegative genital ulcer disease cases were compared. Measuring incidence density in the genital ulcer disease cases directly gave the highest estimate, 6.9% per annum. Screening for the detection of early HIV-1 markers yielded an incidence of 5.0% per annum, while estimating incidence from serial cross-sectional prevalence data and clinic recidivists gave estimates of 3.5% and 4.5% per annum, respectively. These results were found to be internally consistent. Indirect estimates of incidence based on prevalence data can give accurate surrogates of true incidence. Within limitations, even crude measures of incidence are robust enough for health planning and evaluation purposes. (...) |
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