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RITA as part of routine national HIV surveillance: Experience from the United Kingdom Adamma Aghaizu, Jenny Tosswill, Gary Murphy, Meaghan Kall & Valerie Delpech Health Protection Agency, Colindale, London, UK. HIV and AIDS Reporting System.
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RITA as part of routine national HIV surveillance: Experience from the United KingdomAdamma Aghaizu, Jenny Tosswill, Gary Murphy, Meaghan Kall & Valerie DelpechHealth Protection Agency, Colindale, London, UK HIV and AIDS Reporting System HIV and STI Department, Health Protection Agency - Colindale
HIV in the UK • An estimated 100,000 people are living with HIV in the UK • 6500 new diagnoses per year • RITA program began in 2009 • Results returned to patient & integrated as part of routine HIV surveillance
RITA program: Methods • Serum samples from individuals newly diagnosed with HIV tested using the Abbott HIV 1/2 gO avidity assay • AI < 80% are considered possible recent infections • AI 75-85% are retested in duplicate, and mean used • Assay results are linked to reports of new diagnoses report
Patient attends clinic Serum specimen Specimens of individuals newly diagnosed with HIV New HIV diagnosis report Avidity results Health Protection Agency HIV New Diagnosis AIDS and Deaths Database Virus Reference Laboratory Data linked on clinic, clinic id, soundex, DOB and sex Recent Infection Testing Algorithm Database (Test + CD4 count + ART + AIDS history = final RITA result) Survey of Prevalent HIV Infections Diagnosed CD4Surveillance Additional AIDS and ARV data Additional CD4 data The RITA surveillance system local laboratories
Results 2009-2011 • 17,411 new diagnoses E W and NI: 40% MSM , 28% hets women, 19% hets men • RITA coverage: 37% for the 3 years, increasing from 25% in 2009 to 48% in 2011
Proportion of recent HIV infection among newlydiagnosed MSM by age group, England, Wales andNorthern Ireland 2009-2011
Conclusions • 50% coverage of RITA programme over 3 years • High proportion of recent infection among MSM indicating high levels of ongoing transmission, particularly among younger MSM. • RITA results will be incorporated into population incidence estimates in the future. • Outcomes of the CEPHIA programme will enable adjustments for misclassifications. • The role of RITA results in the clinical setting and contact tracing is undergoing further research.