hiv and sti department, health protection agency - colindale hiv and aids reporting system rita as...
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HIV and STI Department, Health Protection Agency - Colindale
HIV and AIDS Reporting System
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 HIV and STI Department, Health Protection Agency - Colindale
HIV and STI Department, Health Protection Agency - Colindale
HIV and AIDS Reporting System
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
HIV and STI Department, Health Protection Agency - Colindale
HIV and AIDS Reporting System
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
HIV and STI Department, Health Protection Agency - Colindale
HIV and AIDS Reporting System
The RITA surveillance system
HIV New Diagnosis AIDS and Deaths Database
HIV New Diagnosis AIDS and Deaths Database
New HIV diagnosis report
Virus Reference LaboratoryVirus Reference Laboratory
Specimens of individuals newly diagnosed with
HIV
Avidity results
Recent Infection Testing Algorithm Database
(Test + CD4 count + ART + AIDS history = final RITA
result)
Recent Infection Testing Algorithm Database
(Test + CD4 count + ART + AIDS history = final RITA
result)
Data linked on clinic, clinic id, soundex, DOB and sex
Health Protection Agency
CD4 Surveillance
CD4 Surveillance
Additional CD4 data
Survey of Prevalent HIV
Infections Diagnosed
Survey of Prevalent HIV
Infections DiagnosedAdditional
AIDS and ARV data
Patient attends clinicPatient attends clinicSerum specimen
local laboratorieslocal laboratories
HIV and STI Department, Health Protection Agency - Colindale
HIV and AIDS Reporting System
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
No. of RITA
results No. Recent % Recent
Probable exposure category
MSM 2772 617 22.3%
Heterosexuals
Men 1115 87 7.8%
Women 1677 137 8.2%
Total 2794 224 8.0%
Injecting drug use 89 6 6.7%
Other/Not Reported 787 88 11.2%
Total 6442 935 14.5%
HIV and STI Department, Health Protection Agency - Colindale
HIV and AIDS Reporting System
Proportion of recent HIV infection among newly
diagnosed MSM by age group, England, Wales and
Northern Ireland 2009-2011
15-24 25-34 35-49 50+ ALL0tan28a566028
0tan4a56604
0tan9a56609
0tan14a566014
0tan19a566019
0tan24a566024
0tan29a566029
0tan4a56604
%
rece
nt in
fect
ion
114
264
203
36
617
HIV and STI Department, Health Protection Agency - Colindale
HIV and AIDS Reporting System
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.