{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:01:58Z","timestamp":1787702518088,"version":"build-2784847793"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,10,26]],"date-time":"2019-10-26T00:00:00Z","timestamp":1572048000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,26]],"date-time":"2019-10-26T00:00:00Z","timestamp":1572048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1115799"],"award-info":[{"award-number":["OPP1115799"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      It is frequently of epidemiological and\/or clinical interest to estimate the date of HIV infection or time-since-infection of individuals. Yet, for over 15\u2009years, the only widely-referenced infection dating algorithm that utilises diagnostic testing data to estimate time-since-infection has been the \u2018Fiebig staging\u2019 system. This defines a number of stages of early HIV infection through various standard combinations of contemporaneous discordant diagnostic results using tests of different sensitivity. To develop a new, more nuanced infection dating algorithm, we generalised the Fiebig approach to accommodate positive and negative diagnostic results generated on the same\n                      <jats:italic>or<\/jats:italic>\n                      different dates, and arbitrary current or future tests \u2013 as long as the test sensitivity is known. For this purpose, test sensitivity is the probability of a positive result as a function of time since infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The present work outlines the analytical framework for infection date estimation using subject-level diagnostic testing histories, and data on test sensitivity. We introduce a publicly-available online HIV infection dating tool that implements this estimation method, bringing together 1) curatorship of HIV test performance data, and 2) infection date estimation functionality, to calculate plausible intervals within which infection likely became detectable for each individual. The midpoints of these intervals are interpreted as infection time \u2018point estimates\u2019 and referred to as Estimated Dates of Detectable Infection (EDDIs). The tool is designed for easy bulk processing of information (as may be appropriate for research studies) but can also be used for individual patients (such as in clinical practice).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In many settings, including most research studies, detailed diagnostic testing data are routinely recorded, and can provide reasonably precise estimates of the timing of HIV infection. We present a simple logic to the interpretation of diagnostic testing histories into infection time estimates, either as a point estimate (EDDI) or an interval (earliest plausible to latest plausible dates of detectable infection), along with a publicly-accessible online tool that supports wide application of this logic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This tool, available at\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/tools.incidence-estimation.org\/idt\/\">https:\/\/tools.incidence-estimation.org\/idt\/<\/jats:ext-link>\n                      , is readily updatable as test technology evolves, given the simple architecture of the system and its nature as an open source project.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-019-4543-9","type":"journal-article","created":{"date-parts":[[2019,10,26]],"date-time":"2019-10-26T12:03:38Z","timestamp":1572091418000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Interpreting HIV diagnostic histories into infection time estimates: analytical framework and online tool"],"prefix":"10.1186","volume":"19","author":[{"name":"on behalf of the Consortium for the Evaluation and Performance of HIV Incidence Assays (CEPHIA)","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7046-7245","authenticated-orcid":false,"given":"Eduard","family":"Grebe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley N.","family":"Facente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Bingham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Pilcher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Powrie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarryd","family":"Gerber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gareth","family":"Priede","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trust","family":"Chibawara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Busch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Murphy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reshma","family":"Kassanjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Welte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,26]]},"reference":[{"issue":"7","key":"4543_CR1","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1097\/QAD.0000000000002190","volume":"33","author":"CD Pilcher","year":"2019","unstructured":"Pilcher CD, Porco TC, Facente SN, Grebe E, Delaney KP, Masciotra S, et al. A generalizable method for estimating duration of HIV infections using clinical testing history and HIV test results. AIDS. 2019;33(7):1231\u201340.","journal-title":"AIDS."},{"issue":"13","key":"4543_CR2","doi-asserted-by":"publisher","first-page":"1871","DOI":"10.1097\/00002030-200309050-00005","volume":"17","author":"EW Fiebig","year":"2003","unstructured":"Fiebig EW, Wright DJ, Rawal BD, Garrett PE, Schumacher RT, Peddada L, et al. Dynamics of HIV viremia and antibody seroconversion in plasma donors: implications for diagnosis and staging of primary HIV infection. AIDS. 2003;17(13):1871\u20139.","journal-title":"AIDS."},{"issue":"2","key":"4543_CR3","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/j.jtbi.2009.07.038","volume":"261","author":"HY Lee","year":"2009","unstructured":"Lee HY, Giorgi EE, Keele BF, Gaschen B, Athreya GS, Salazar-Gonzalez JF, et al. Modeling sequence evolution in acute HIV-1 infection. 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Where the tool has been used to estimate time of infection of subjects contributing specimens to the CEPHIA repository, those analyses were performed under CEPHIA study procedures approved by the University of California San Francisco Institutional Review Board (approval #10\u201302365), and all specimens were collected under IRB-approved research protocols.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable: No data from human subjects are reported in this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"894"}}