Researchers Develop More Accurate Tool to Identify New HIV Infections

Researchers at the Duke Human Vaccine Institute have spearheaded an effort to develop a more precise way of determining the incidence of HIV infections in large populations, according to a press release from the institute.

The method more accurately identifies new versus long-standing infections, an important distinction when determining where to target public health initiatives and research, according to senior author Georgia Tomaras, PhD, Department of Surgery, director of research, Duke Human Vaccine Institute. The method will also provide benefit when evaluating whether interventions are successful at reducing HIV transmission.

“Recent advances—including effective antiretroviral drugs that both treat and prevent HIV infections—have changed the landscape in the HIV field,” said Tomaras in a statement. “Improved methods for classifying recent infection from older infections are critically needed to help identify the most effective prevention strategies.”

While a number of assays that look at HIV incidence have been developed, the institute has improved upon them by being able to decrease the false recent rate in those assays as well as being able to determine recent versus long-standing infection in the presence of antiretroviral treatment, said Tomaras in an interview with Duke Health.

“The currently available assays are not accurately estimating HIV incidence,” said Tomaras. “They don’t have an appropriate window for identifying recent from long-standing infection. They also have a relatively high false recent rate, so they’re misclassifying people as long-standing or recent infections.”

The research team at the Duke Human Vaccine Institute performed a retrospective analysis of patients with HIV infection over time to profile their circulating antibody response to the HIV virus. According to Tomaras, the methods that they used harnessed early findings of looking at the immune response to HIV infection and developed a binding assay that could look at the reactivity of the antibodies to the different regions of the HIV virus, the strength of the interaction, and the maturation of that response over time.

The team then used a computational analysis to pull the different measurements together to try and identify a combination of biomarkers that could accurately measure and distinguish recently infected versus long-standing infection.

“The improvements seen with this set of biomarkers are a tremendous benefit to the field because they allow for public health researchers, epidemiologists, and those treating HIV to more effectively target prevention and treatment strategies by having an accurate handle on the epidemic, where hot spots are occurring, and who’s becoming recently infected versus who’s been infected for a long time,” said Kelly Seaton, PhD, associate research lab manager, Duke Human Vaccine Institute, during the Duke Health interview.

“The research has progressed to the point now that we are ready to begin development of a kit, which would put this into the field in the hands of people who could measure incidence at regional, state, and national levels.”