Pastor, LucíaCasellas, AinaCarrillo Molina, JorgeAlonso, SergiParker, EricaFuente Soro, LauraJairoce, Chenjerai Tobias SixpenceMandomando, InácioBlanco, JuliàNaniche, Denise2017-09-262017-09-262017-08-142045-2322https://hdl.handle.net/2445/115803Acute HIV infection (AHI) is the period prior to seroconversion characterized by high viral replication, hyper-transmission potential and commonly, non-specific febrile illness. AHI detection requires HIV-RNA viral load (VL) determination, which has very limited access in low-income countries due to restrictive costs and implementation constraints. We sought to identify a biomarker that could enable AHI diagnosis in scarce-resource settings, and to evaluate the feasibility of its implementation. HIV-seronegative adults presenting at the Manhica District Hospital, Mozambique, with reported-fever were tested for VL. Plasma levels of 49 inflammatory biomarkers from AHI (n = 61) and non-HIV infected outpatients (n = 65) were determined by Luminex and ELISA. IP-10 demonstrated the best predictive power for AHI detection (AUC = 0.88 [95%CI 0.80-0.96]). A cut-off value of IP-10 >/= 161.6 pg/mL provided a sensitivity of 95.5% (95%CI 85.5-99.5) and a specificity of 76.5% (95%CI 62.5-87.2). The implementation of an IP-10 screening test could avert from 21 to 84 new infections and save from US$176,609 to US$533,467 to the health system per 1,000 tested patients. We conclude that IP-10 is an accurate biomarker to screen febrile HIV-seronegative individuals for subsequent AHI diagnosis with VL. Such an algorithm is a cost-effective strategy to prevent disease progression and a substantial number of further HIV infections.9 p.application/pdfengcc by (c) Pastor et al., 2017http://creativecommons.org/licenses/by/4.0/VIH (Virus)CribratgeHIV (Viruses)Medical screeninginfo:eu-repo/semantics/article2017-09-06info:eu-repo/semantics/openAccess28808319