A comparison of biomarker based incidence estimators
Date
2009-10
Authors
McWalter, Thomas A.
Welte, Alex
Journal Title
Journal ISSN
Volume Title
Publisher
Public Library of Science (PLOS)
Abstract
Background: Cross-sectional surveys utilizing biomarkers that test for recent infection provide a convenient and cost effective way to estimate HIV incidence. In particular, the BED assay has been developed for this purpose. Controversy surrounding the way in which false positive results from the biomarker should be handled has lead to a number of different estimators that account for imperfect specificity. We compare the estimators proposed by McDougal et al., Hargrove et al. and McWalter & Welte. Methodology/Principal Findings: The three estimators are analyzed and compared. An identity showing a relationship between the calibration parameters in the McDougal methodology is shown. When the three estimators are tested under a steady state epidemic, which includes individuals who fail to progress on the biomarker, only the McWalter/ Welte method recovers an unbiased result. Conclusions/Significance: Our analysis shows that the McDougal estimator can be reduced to a formula that only requires calibration of a mean window period and a long-term specificity. This allows simpler calibration techniques to be used and shows that all three estimators can be expressed using the same set of parameters. The McWalter/Welte method is applicable under the least restrictive assumptions and is the least prone to bias of the methods reviewed. © 2009 McWalter, Welte.
Description
The original publication is available at http:/www.plosone.org
Keywords
HIV infections -- Epidemiology -- South Africa, Biochemical markers, McDougal estimator, BED assay
Citation
McWalter, T.A. & Welte, A. 2009. A comparison of biomarker based incidence estimators. PLoS ONE, 4(10):e7368. doi:10.1371/journal.pone.0007368.