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Mee-Kyung Kee 6 Articles
Modification of AxSYM Human Immunodeficiency Virus Assay to Identify Recent Human Immunodeficiency Virus Infections in Korean Human Immunodeficiency Virus-Positive Individuals
Jin-Sook Wang, Mee-Kyung Kee, Byeong-Sun Choi, Sung Soon Kim
Osong Public Health Res Perspect. 2015;6(3):184-191.   Published online June 30, 2015
DOI: https://doi.org/10.1016/j.phrp.2015.06.002
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  • 18 Download
  • 1 Citations
AbstractAbstract PDF
Objectives
To estimate human immunodeficiency virus (HIV) incidence using HIV avidity assays in Korea, we established a serological testing method to differentiate recent HIV infections from long-standing ones.
Methods
We adopted two incidence assays, the BED HIV-1 incidence test (Calypte Biomedical) and an HIV avidity assay (using Abbott AxSYM HIV Antigen/Antibody Combo), and performed them on Korean HIV samples obtained from 81 HIV seroconverters (n = 193), 135 HIV-positive samples, and three HIV commercial incidence panels (PRB965, PRB933, and PRB601 from SeaCare). To determine the most optimal concentration of the chaotropic agent (Guanidine) and the cutoff value for the avidity assay, we evaluated the sensitivity and specificity of the assay at different concentration levels.
Results
We determined that the concentration of Guanidine to be used in the avidity assay was 1.5M. The cutoff value of the avidity index (AI) was 0.8, and the sensitivity and specificity were 90.2% and 83.8%, respectively, under this condition. The gray zone for the avidity assay was 0.75–0.85 AI. The mean of coefficient of variation was low, at 5.43%.
Conclusion
An optimized avidity assay for the diagnosis of recent HIV infections using Korean samples was established. This assay will be applied to investigate the level of recent infection and will provide basic data to the HIV prevention policy in Korea.
The Recency Period for Estimation of Human Immunodeficiency Virus Incidence by the AxSYM Avidity Assay and BED-Capture Enzyme Immunoassay in the Republic of Korea
Hye-Kyung Yu, Tae-Young Heo, Na-Young Kim, Jin-Sook Wang, Jae-Kyeong Lee, Sung Soon Kim, Mee-Kyung Kee
Osong Public Health Res Perspect. 2014;5(4):187-192.   Published online August 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.06.002
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  • 1 Citations
AbstractAbstract PDF
Objectives
Measurement of the incidence of the human immunodeficiency virus (HIV) is very important for epidemiological studies. Here, we determined the recency period with the AxSYM avidity assay and the BED-capture enzyme immunoassay (BED-CEIA) in Korean seroconverters.
Methods
Two hundred longitudinal specimens from 81 seroconverters with incident HIV infections that had been collected at the Korea National Institute of Health were subjected to the AxSYM avidity assay (cutoff = 0.8) and BED-CEIA (cutoff = 0.8). The statistical method used to estimate the recency period in recent HIV infections was nonparametric survival analyses. Sensitivity and specificity were calculated for 10-day increments from 120 days to 230 days to determine the recency period.
Results
The mean recency period of the avidity assay and BED-CEIA using a survival method was 158 days [95% confidence interval (CI), 135–181 days] and 189 days (95% CI, 170–208 days), respectively. Based on the use of sensitivity and specificity, the mean recency period for the avidity assay and BED-CEIA was 150 days and 200 days, respectively.
Conclusion
We determined the recency period to estimate HIV incidence in Korea. These data showed that the nonparametric survival analysis often led to shorter recency periods than analysis of sensitivity and specificity as a new method. These findings suggest that more data from seroconverters and other methodologies are needed to determine the recency period for estimating HIV incidence.
Forecasting the Number of Human Immunodeficiency Virus Infections in the Korean Population Using the Autoregressive Integrated Moving Average Model
Hye-Kyung Yu, Na-Young Kim, Sung Soon Kim, Chaeshin Chu, Mee-Kyung Kee
Osong Public Health Res Perspect. 2013;4(6):358-362.   Published online December 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.10.009
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  • 21 Citations
AbstractAbstract PDF
Objectives
From the introduction of HIV into the Republic of Korea in 1985 through 2012, 9,410 HIV-infected Koreans have been identified. Since 2000, there has been a sharp increase in newly diagnosed HIV-infected Koreans. It is necessary to estimate the changes in HIV infection to plan budgets and to modify HIV/AIDS prevention policy. We constructed autoregressive integrated moving average (ARIMA) models to forecast the number of HIV infections from 2013 to 2017.
Methods
HIV infection data from 1985 to 2012 were used to fit ARIMA models. Akaike Information Criterion and Schwartz Bayesian Criterion statistics were used to evaluate the constructed models. Estimation was via the maximum likelihood method. To assess the validity of the proposed models, the mean absolute percentage error (MAPE) between the number of observed and fitted HIV infections from 1985 to 2012 was calculated. Finally, the fitted ARIMA models were used to forecast the number of HIV infections from 2013 to 2017.
Results
The fitted number of HIV infections was calculated by optimum ARIMA (2,2,1) model from 1985–2012. The fitted number was similar to the observed number of HIV infections, with a MAPE of 13.7%. The forecasted number of new HIV infections in 2013 was 962 (95% confidence interval (CI): 889–1,036) and in 2017 was 1,111 (95% CI: 805–1,418). The forecasted cumulative number of HIV infections in 2013 was 10,372 (95% CI: 10,308–10,437) and in 2017 was14,724 (95% CI: 13,893–15,555) by ARIMA (1,2,3).
Conclusion
Based on the forecast of the number of newly diagnosed HIV infections and the current cumulative number of HIV infections, the cumulative number of HIV-infected Koreans in 2017 would reach about 15,000.
Immune Status and Epidemiological Characteristics of Human Immunodeficiency Virus Seroconverters in Korea, 1999–2009
Jin-Sook Wang, Na-young Kim, Hyo Jung Sim, Byeong-Sun Choi, Mee-Kyung Kee
Osong Public Health Res Perspect. 2012;3(4):245-249.   Published online December 31, 2012
DOI: https://doi.org/10.1016/j.phrp.2012.11.001
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  • 3 Citations
AbstractAbstract PDF
Objectives
The detection of HIV seroconverters increased annually since HIV antigen/antibody testing kits have been available widely in South Korea. This study aimed to identify the epidemiological characteristics of HIV seroconverters and their immune level at HIV diagnosis.
Method
We analyzed the epidemiological and immunological characteristics of 341 HIV seroconverters among 6,008 HIV-diagnosed individuals from 1999 and 2009. The analysis of immune level and epidemiological factors of HIV seroconverters was conducted by using chi-square test on SAS version 9.1.
Results
The seroconverters among newly-identified HIV cases each year increased from 0.5% in 1999 to over 5% or in 2009. The sex ratio of seroconverters was 18:1 (male:female), and 33% were in their 30s, and 28% were in their 20s. Reasons for HIV testing were involvement in voluntary test due to risky behaviors (43%), and health check-up (36%). Discovery of HIV infection occurred primarily in hospitals (84%). Among seroconverters, 55 percent had a CD4 T-cell count of more than 350/μl.
Conclusion
Korean HIV seroconverters tended to be younger at diagnosis, diagnosed during a voluntary test, and their CD4+ T-cell counts at HIV diagnosis were higher than those of non-seroconverters aall HIV-infected individuals. This study of HIV seroconverters will be important foundational in future studies on HIV incidence, disease progress, and survival rate.
Epidemiological and Immunological Characteristics at the Time of HIV Diagnosis for HIV/AIDS Cohort Registrants Representative of HIV-Infected Populations in Korea
Jin-Hee Lee, Seung Hyun Kim, Jin-Sook Wang, Kyoung Mi Sung, Sung Soon Kim, Mee-Kyung Kee
Osong Public Health Res Perspect. 2012;3(2):100-106.   Published online June 30, 2012
DOI: https://doi.org/10.1016/j.phrp.2012.04.002
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  • 2 Citations
AbstractAbstract PDF
Objectives
The Korea HIV/AIDS cohort was constructed with 18 hospitals that care for HIV-infected individuals in 2006. We compared the epidemiological and immunological characteristics of the cohort registrants with those of the HIVinfected population at the time of HIV diagnosis.
Methods
This study was conducted on 5717 people living with HIV/AIDS from 1985 to 2009, of which 789 individuals registered with the Korea HIV/AIDS cohort study. Individuals who had data from initial CD4+ T-cell counts measured within 6 months following HIV diagnosis were selected as study participants to predict the status of disease progression at the time of HIV diagnosis. A total of 2886 patients (50%) were selected from people living with HIV/AIDS, of whom 424 individuals (54%) were cohort registrants. The χ2 test and Wilcoxon rank sum test were used for analysis.
Results
The distributions of age, marital status, diagnosed regions, reason for HIV testing, and screening site were similar between the HIV-infected population and the cohort registrants. In 1985–2004, the male ratio for the cohort registrants (94.3%) was significantly higher than that measured for the HIV-infected population (89.5%) (p = 0.0339). With regard to transmission route, homosexual contact of cohort registrants (46.6%) was higher than that of the HIV-infected population (40.1%) (p = 0.022) in 2005–2009. No statistical difference in CD4+ T-cell counts at the time of HIV diagnosis was found between the HIVinfected population and cohort registrants (p = 0.2195).
Conclusion
The Korea HIV/AIDS cohort registrants represent the HIV-infected population, and the data collected from this cohort could be used as a foundation for national statistics.
Estimation of HIV Seroprevalence in Colorectal Hospitals by Questionnaire Survey in Korea, 2002–2007
Mee-Kyung Kee, Do Yeon Hwang, Jong Kyun Lee, Seung Hyun Kim, Chaeshin Chu, Jin-Hee Lee, Sung Soon Kim
Osong Public Health Res Perspect. 2011;2(2):104-108.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.08.002
  • 1,875 View
  • 15 Download
  • 4 Citations
AbstractAbstract PDF
Objectives
The incidence of anal disease is higher among persons with human immunodeficiency virus (HIV) infection than among the general population. We surveyed the status of seroprevalence in colorectal hospitals in Korea.
Methods
The survey was conducted in colorectal hospitals in Korea from November to December 2008. The questionnaire was comprised of six topics about the status of HIV testing in colorectal hospitals. We gathered the data by website (http://hivqa.nih.go.kr/risk) or fax.
Results
Among 774 colorectal hospitals contacted, 109 (14%) hospitals participated in the survey. Among these, 48 hospitals (44%) performed HIV tests in their own hospitals and 11 (23%) took HIV testing by rapid method. The main reason for recommending an HIV test was surgical operation (54%) followed by endoscope (11%) and health checkup (9%). The annual number of HIV tests increased from 58,647 (at 21 hospitals) in 2002 to 246,709 (at 58 hospitals) in 2007. HIV seroprevalence was >3.0 per 10,000 individuals during 2002–2005, decreased to 2.2 per 10,000 individuals in 2006 and rose to 2.8 per 10,000 individuals in 2007.
Conclusions
HIV seroprevalence of colorectal hospitals was more than twice that of general hospitals in Korea. HIV surveillance systems based on colorectal hospitals for HIV/AIDS transmission prevention by early HIV diagnosis are needed.

PHRP : Osong Public Health and Research Perspectives