Development and validation of a risk score to assist screening for acute HIV-1 infection among men who have sex with men

Table 3 Prevalence of symptoms and risk factors and their association with HIV-1 seroconversion^a

Column 1	2		3		4	5	6	7	8
Symptom	Seroconversion visit n%		HIV negative visit n%		OR (95% CI)	Symptom based model aOR (95% CI)^b	Beta coefficient^c,d	Combined model aOR (95% CI)^e	Beta coefficient^c,f
Total^g	175		17,271
Symptom
Diarrhea	30	17.1	1011	5.9	3.3 (2.2–4.8)	1.3 (0.8–2.1)	0.3	1.5 (0.9–2.4)	0.4
Fatigue	42	24.0	1867	10.8	2.6 (1.8–3.6)	1.2 (0.8–1.9)	0.2	1.4 (0.9–2.2)	0.3
Fever	76	43.4	1623	9.4	7.2 (5.4–9.8)	5.0 (3.5–7.1)^h	1.6	4.7 (3.2–7.0)^h	1.6
Genital ulcers	11	6.3	324	1.9	3.5 (1.9–6.4)	2.6 (1.3–5.0)^h	0.9	1.6 (0.6–4.0)	0.5
Headache	18	10.3	980	5.7	1.9 (1.2–3.1)	0.7 (0.4–1.3)	−0.3	0.8 (0.4–1.5)	−0.2
Lymphadenopathy	27	15.4	418	2.4	7.2 (4.7–10.9)	3.3 (2.1–5.4)^h	1.2	4.4 (2.6–7.3)^h	1.5
Myalgia	25	14.3	869	5.0	3.1 (2.0–4.7)	1.1 (0.7–1.9)	0.1	1.4 (0.8–2.4)	0.3
Nausea	18	10.3	526	3.1	3.6 (2.2–5.8)	0.8 (0.4–1.7)	−0.2	0.9 (0.4–1.9)	−0.1
Night sweats	32	18.3	832	4.8	4.3 (3.0–6.4)	1.2 (0.8–2.0)	0.2	1.2 (0.7–2.1)	0.2
Oral thrush	4	2.3	36	0.2	10.8 (3.8–30.7)	5.0 (1.5–16.3)^h	1.6	5.6 (1.4–22.3)^h	1.7
Rash	11	6.3	564	3.3	2.0 (1.1–3.6)	1.2 (0.6–2.4)	0.2	0.6 (0.3–1.4)	−0.5
Sore throat	31	17.7	1316	7.6	2.6 (1.7–3.8)	1.0 (0.7–1.6)	0.0	0.9 (0.5–1.4)	−0.2
Vomiting	17	9.7	336	2.0	5.3 (3.2–8.8)	1.8 (0.9–3.8)	0.6	1.4 (0.6–3.3)	0.4
Weight loss	11	6.3	205	1.2	5.5 (2.9–10.2)	1.9 (1.0–3.9)	0.7	2.4 (1.1–5.2)^h	0.9
Risk factor
Gonorrhea^i,j	12	6.9	181	1.1	6.5 (3.6–12.0)			4.9 (2.3–10.2)^h	1.6
Receptive CLAIⁱ	97	55.4	5651	32.7	2.7 (2.0–3.7)			3.0 (2.1–4.2)^h	1.1
>5 sexual partners^i,k	100	57.1	7659	44.4	2.4 (1.7–3.4)			2.5 (1.7–3.6)^h	0.9

aOR adjusted odds ratio. CI confidence interval, CLAI condomless anal intercourse, OR odds ratio
^aIn Amsterdam Cohort Studies, based on imputed data using the last observation carried forward method
^b14 symptoms in column 1 were included in a multivariable logistic regression model using generalized estimating equations
^cNatural log of the adjusted odds ratio, rounded to one decimal
^dBased on the adjusted odds ratios of the symptom-based model (column 5)
^e14 symptoms and 3 risk factors in column 1 were included in a multivariable logistic regression model using generalized estimating equations
^fBased on the adjusted odds ratios of the combined symptom and risk factor model (column 7)
^gDue to missing values, the denominator of columns 2 and 3 are sometimes not equal to 175 respectively 17,271. Data missing for the following variables: fever, 1 missing; genital ulcers, 3 missings; gonorrhea, 2072 missings; receptive condomless anal intercourse, 162 missings; >5 sexual partners, 56 missings
^hSignificantly associated with HIV-1 seroconversion
ⁱIn the preceding 6 months
^jSelf-reported
^kOnly male sex partners, compared to ≤5 sexual partners

ISSN: 1471-2334