HIV-Testing Algorithm and Exclusion criteria Survey 1.

<p>In Survey 1 we tested 1,889 whole blood specimen and 14,448 plasma specimen with the Determine HIV1/2 RDT. The confirmation algorithm included two different ELISAs and one Western Blot. If both ELISAs were in agreement their result was used as the reference standard result. Samples with discordant ELISA results were retested by Western Blot and the Western Blot result used. Samples with indeterminate Western Blot results were excluded from analysis. Negative RDT results were not directly confirmed, but regarded as true negative if the result of the following survey was also negative. Whole blood results where confirmation by ELISA testing was impossible due to lack of plasma, were regarded as true positive if the result in the next survey was confirmed positive and as false positive if a negative test result in the next survey was confirmed using the above reference algorithm. Results where the true HIV status could not be verified according to the reference algorithm were excluded from this analysis.</p

Spatial autocorrelation of <i>T</i>. <i>trichiura</i> infection between and within households in Kyela.

<p>The red line shows Moran’s I of spatial autocorrelation for the raw data. The blue and green lines show the autocorrelation of deviance residuals for the models M1 and M2, respectively. The horizontal axis shows the distance bands between households.</p

Location of the EMINI study area.

<p>The study area consists of nine distinct study sites. Participating household are shown as red circles.</p

Multivariable association of different factors with <i>T</i>. <i>trichiura</i> infection in Kyela.

<p>Results of multivariable Poisson regression models adjusted for household clustering using robust variance estimates (N = 912). Multivariable results are only shown for those variables that were included into the respective model.</p

Characteristics of the study population and environmental conditions at their place of residence.

<p>Characteristics of the study population and environmental conditions at their place of residence.</p

Prevalence of <i>T</i>. <i>trichiura</i> infection in the nine EMINI study sites in Mbeya region, Tanzania (A) and details for Kyela site (B).

<p>Households with at least one infected person are represented by red Voronoi polygons, households without are shown in green. Subsite A and B in this text refer to the western and eastern part of Kyela, respectively.</p

Group characteristics and immunological results of the 96 subjects enrolled in the cross-sectional study.

<p>NA = not applicable; ART = antiretroviral treatment; PPD⁺ CD27 Ratio = number of PPD-specific CD4 T cells positive for IFN gamma divided by the number of respective CD27⁻ CD4 T cells.</p><p>*Diagnostic concordance MTB culture defines the proportion of concordant results defined by PPD response and CD27 expression of PPD-specific CD4 T cells.</p

Association of various factors with false positive STAT-PAK RDT results in plasma; uni- and multi-variable log-link binomial regression results adjusted for clustering within household (N = 11969).

<p>PR  =  probability ratio for a false positive result; p  =  p-value; 95% CI  = 95% confidence interval.</p><p><i>P. falciparum</i> infection not included due to empty cells (no false positive results in <i>P. falciparum</i> infected participants because of low <i>P. falciparum</i> prevalence in survey 2).</p>*<p>variables were only retained in multi-variable model if uni-variable p-value <0.2.</p

Characterization of CD27 expression on PPD-specific CD4 T cells in whole blood.

<p>(A) The cut off for CD27 expression was determined based on the corresponding isotype control for each antibody. Shown is a representative staining for IFNγ-FITC and CD27-PE as well as their corresponding IgG₁ isotype controls that were used to determine the cut off. (B) Gating strategy to identify PPD-specific CD4 T cells and to analyse the CD27 expression on IFNγ-positive CD4 T cells after 6 h of PPD-stimulation during the cross-sectional study. (C) Representative staining for negative and positive controls using PPD diluent and SEB, respectively, for stimulation.</p

Down regulation of CD27 on PPD-specific CD4 T cells is associated with active Tuberculosis independent of the HIV status and with progression to active TB in a HIV⁺ seroconverter.

<p>(A) Ratio of IFNγ⁺ CD4 T cells that are CD27⁺ divided by those that are CD27⁻ is shown for 4 different groups of PPD responders delineated by TB disease state and by HIV serology. CD4⁺ T cells were analyzed for each sample using a whole blood intracellular cytokine assay. (B) Histogram analysis of CD27 expression on IFNγ⁺ PPD-specific CD4 T cells (blue line) and total CD4 T cells (black line, grey) over a 15 months period in two subjects who became HIV infected. Subject H19 (<b>upper panel</b>) was diagnosed and treated for active TB 15 months after HIV infection. Subject H228 (<b>lower panel</b>) did not develop TB within three years after HIV infection. Longitudinal analysis of CD27 expression for one subject was determined simultaneously by flow cytometry.</p