MedicalResearch.com Interview with:
Dr. Martin Hoenigl
Center for AIDS Research
University of California, San Diego
Medical Research: What is the background for this study? What are the main findings?
Dr. Hoenigl: Although men who have sex with men (MSM) represent a dominant risk group for human immunodeficiency Virus, the risk of HIV infection within this population is not uniform. Characterizing and identifying the MSM at greatest risk for incident HIV infection might permit more focused delivery of both prevention resources and selection of appropriate interventions, such as intensive counseling, regular HIV screening with methods that detect acute infection (ie, nucleic acid amplification test), and antiretroviral preexposure prophylaxis (PrEP).
By using data collected at a single HIV testing encounter from 8326 unique MSM were analyzed, including 200 with AEH (2.4%), we were able to create the San Diego Early Test (SDET) risk score. The SDET score consist of four risk behavior variables which were significantly associated with an AEH diagnosis (ie, incident infection) in multivariable: condomless receptive anal intercourse (CRAI) with an HIV-positive MSM (3 points), the combination of CRAI plus 5 or more male partners (3 points), 10 or more male partners (2 points), and diagnosis of bacterial sexually transmitted infection (2 points), all as reported for the prior 12 months. The SDET risk score is deployed as a freely available tool at http://sdet.ucsd.edu.
Medical Research: What should clinicians and patients take away from your report?
Dr. Hoenigl: This score may help to prioritize resources and target interventions, such as PrEP, to MSM at greatest risk of acquiring HIV infection. By using a cutoff of 5, the score may help to identify persons who require more intensive prevention interventions such as PrEP or more frequent nucleic acid amplification test testing, while a cutoff of 6 may be helpful in guiding immediate ART in those with acute and early HIV infection (the cutoff exhibited a NPV of 94% for transmitted drug resistance among those with acute and early HIV infection).
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Hoenigl: Optimally, the SDET score should undergo additional validation in other US and international populations to confirm its accuracy.
Development and Validation of the San Diego Early Test Score to Predict Acute and Early HIV Infection Risk in Men Who Have Sex With Men
Hoenigl M1, Weibel N2, Mehta SR3, Anderson CM4, Jenks J4, Green N4, Gianella S4, Smith DM3, Little SJ4.
Clin Infect Dis. 2015 Apr 22. pii: civ335. [Epub ahead of print]
MedicalResearch.com Interview with: Dr. Martin Hoenigl, Center for AIDS Research, & University of California, San Diego (2015). Risk Score May Help Identify MSM Most In Need Of HIV Prevention Resources MedicalResearch.com