Benjamin Armbruster, PhD
Potential Conflicts of Interest: None disclosed.
Armbruster B. Two Additional Implications of an HIV Nucleic Acid Testing Program With Automated Internet and Voicemail Systems to Deliver Results. Ann Intern Med. 2010;153:549. doi: 10.7326/0003-4819-153-8-201010190-00018
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Published: Ann Intern Med. 2010;153(8):549.
TO THE EDITOR:
Morris and colleagues' study (1) finds that nucleic acid testing (NAT) will identify many HIV infections that are not detected with HIV antibody tests. Two additional implications of the study were not discussed: a remarkably high incidence rate and a significant tendency for patients to seek testing shortly after a suspected infection.
Of the 3151 patients tested in the study, 35 had acute or early infections, infections that are less than 133 days old (95% CI, 113 to 160 days). This suggests an incidence rate (r) of 3.1% per year (CI, 2.1% to 4.3%): r = (35/3151)/133 × 365. For comparison, the Centers for Disease Control and Prevention estimate that men who have sex with men (MSM) make up 4% of the U.S. male population aged 13 years or older (implying an estimate of 5 million people for 2006) (2) and that 28 700 new HIV infections occurred in the United States among MSM in 2006 (3). This implies an incidence rate of 0.6% per year among MSM.
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