Evaluation of an empiric risk screening score to identify acute and early HIV-1 infection among MSM in Coastal Kenya

• DOI: 10.1097/qad.0b013e3283629095
• Publication Date: 2013-07-10T12:32:14Z
• Authors: Elizabeth Wahome; Greg Fegan; Haile S. Okuku; Peter Mugo; Matthew A. Price; Grace Mwashigadi; Alexander Thiong’o; Susan M. Graham; Eduard J. Sanders
• Keywords: Adult; Male; 610; HIV Infections; Kenya; Risk Assessment; Research Letters; 3. Good health; Cohort Studies; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Predictive Value of Tests; Area Under Curve; 616; HIV-1; Humans; Female; Homosexuality, Male

We evaluated the University of North Carolina-Malawi Risk Screening Score (UMRSS) for detection of acute and early HIV-1 infection (AEHI) in a cohort of Kenyan MSM with approximately 8% annual HIV-1 incidence. Three components of the UMRSS (fever, diarrhea, and discordant rapid HIV tests) were also independent predictors of AEHI in our cohort. The predictive ability (area under the receiver operating characteristic curve, AUC) of the UMRSS was 0.79. A cohort-derived risk score consisting of six characteristics (fever, diarrhea, discordant rapid HIV tests, fatigue, age <30 years, and symptomatic sexually transmitted disease) had a higher AUC of 0.85. Screening for AEHI will have substantial transmission prevention benefits.