Antiretroviral therapy (ART) can impact assays used for cross-sectional HIV incidence testing, causing inaccurate HIV incidence estimates. We evaluated the relationship between the timing of ART initiation and the performance of two serologic HIV incidence assays. We analyzed 302 samples from 55 individuals from the RV217 cohort (Early Capture HIV Cohort Study). Participants were grouped by ART start time: ART started <1 year after infection (N = 9); ART started 1–3 years after infection (N = 12); and never received ART (N = 34). Samples were tested using the Sedia LAg-Avidity and Johns Hopkins modified Bio-Rad-Avidity assays. Results were compared with those from the Johns Hopkins HIV Cohort in which participants initiated ART an average of 10 years after infection (N = 17). Participants on ART were virally suppressed at the time of sample collection. The increase in normalized optical density (ODn) values was an average of 2.15 U/year lower in participants who started ART <1 year after infection than in those who did not start ART. Participants who started ART 1–3 years after infection had a decline in ODn values 0.90 U/year faster compared with those who started ART an average of 10 years after infection. Timing of ART initiation did not significantly impact results obtained with the Bio-Rad-Avidity assay. ART initiation <1 year after HIV infection was associated with persistently low limiting antigen (Lag)-Avidity values; this could lead to overestimation of HIV incidence. LAg-Avidity values declined more rapidly the earlier ART was initiated. Bio-Rad-Avidity values were not impacted by the timing of ART initiation.

中文翻译：

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早期抗逆转录病毒治疗启动对跨部门发病率分析性能的影响。

抗逆转录病毒疗法（ART）可能会影响用于横断面HIV发病率测试的检测方法，从而导致HIV发病率估算不准确。我们评估了ART起始时间与两种血清学HIV发病率检测方法之间的关系。我们分析了来自RV217队列（早期捕获HIV队列研究）的55个个体的302个样本。参与者按抗病毒治疗开始时间分组：抗病毒治疗开始于感染后不到1年（N  = 9）；感染后1-3年开始抗病毒治疗（N  = 12）；从来没有收到过ART（N = 34）。使用Sedia LAg-Avidity和Johns Hopkins改良的Bio-Rad-Avidity测定法测试样品。将结果与Johns Hopkins HIV队列的结果进行比较，在该研究中，参与者在感染后平均10年开始进行抗逆转录病毒治疗（N = 17）。收集样本时，抗病毒治疗的参与者受到病毒抑制。感染后一年内开始抗病毒治疗的参与者的标准化光密度（ODn）值平均比不开始抗病毒治疗的参与者低2.15 U /年。与感染后平均10年开始进行抗逆转录病毒治疗的参与者相比，感染后1-3年开始抗逆转录病毒治疗的参与者的ODn值下降速度快0.90 U /年。ART启动的时间不会显着影响通过Bio-Rad-Avidity分析获得的结果。HIV感染后<1年的ART开始与持续低的极限抗原（Lag）-亲和力值相关；这可能导致高估艾滋病毒的发病率。早期抗逆转录病毒治疗开始后，LAg亲和力值下降得更快。