The most recent meeting of the steering committee of the WHO Technical Working Group on HIV
Incidence Assays took place on 26–27 September 2012 at WHO headquarters in Geneva, Switzerland.
This meeting follows the August 2011 Working Group meeting that took place in Atlanta, Georgia, USA
and addresses the key outcomes of that meeting (1). This report documents the meeting’s objectives,
outcomes, main discussion points and next steps for the Working Group meeting that is proposed to
take place in about 12 months.
In 2008, WHO established a Technical Working Group on HIV Incidence Assays to examine the
issues and challenges involved in assay-based estimation of HIV incidence. This group has worked to
standardize terms in the areas of assay calibration, validation and use for estimating incidence. Several
meetings to advance this agenda have been held, and copies of reports are available on the Working
Group web page (http://www.who.int/diagnostics_laboratory/links/hiv_incidence_assay/en). These
meetings have been successful in bringing together a wider group of assay users, especially those
from countries affected by the epidemic who may consider using HIV incidence assays in the future
together with key experts on applying laboratory-based methods for estimating HIV incidence. The
importance of HIV incidence as a key indicator of national programme success or failure has been
highlighted, and health ministries clearly need to be aware of the complexities of producing estimates
based on data generated by the currently available assays.
The UNAIDS and WHO five-year strategies for 2011–2015 aim to significantly reduce the incidence
of HIV infection, and even though there is no clear consensus on how to measure incidence in all
countries, tests for recently acquired infection provide one method for estimating HIV incidence and
can be especially useful in countries with a high burden of HIV infection.
In 2010, the Gates Foundation awarded a grant to the United Kingdom Health Protection Agency
and the Blood Systems Research Institute to develop a specimen repository and evaluate existing
HIV incidence assays. The approved proposal has five main objectives and aims to validate the
performance of existing and future HIV incidence assays when used with different samples from the
sample repository created and to identify the key parameters to enable the laboratory results to be
correctly interpreted. The grant is for two years, and progress on the work was presented at the 19th
International AIDS Conference in Washington, DC in July 2012. Information on the Consortium for the
Evaluation and Performance of HIV Incidence Assays (CEPHIA) is available at http://www.incidenceestimation.com/page/cephia-overview.