Challenges and Opportunities for the Implementation of Virological Testing in resource-limited settings
AffiliationMédecins Sans Frontières Access Campaign, Geneva, Switzerland. email@example.com
MetadataShow full item record
AbstractThough the advantages of routine virological monitoring for patients on anti-retroviral therapy have been established, cost and complexity limit its full implementation. Monitoring is important for diagnosing virological failure early on, before the development of drug resistance mutations, and to trigger early adherence interventions. Simple and cost-effective viral load tests that facilitate simplification and decentralization of testing and strategies, such as the use of dried blood spots and pooled sample testing, which further aid simplification, are becoming available. In addition, replacing immunological monitoring with virological monitoring in non-viremic patients in a phased manner will reduce the costs associated with dual immuno-virological monitoring. Going forward, the simplification of testing paired with price reducing strategies that will allow for healthy competition between multiple manufacturers will enable the implementation of viral load testing in resource-poor settings. It is important that future HIV and AIDS treatment guidelines provide clear recommendations for routine virological monitoring and that governments and donors fund the implementation of accurate and operationally proven testing platforms in a comprehensive manner.
- Dried blood spots can expand access to virological monitoring of HIV treatment in resource-limited settings.
- Authors: Johannessen A, Trøseid M, Calmy A
- Issue date: 2009 Dec
- Pooling strategies to reduce the cost of HIV-1 RNA load monitoring in a resource-limited setting.
- Authors: van Zyl GU, Preiser W, Potschka S, Lundershausen AT, Haubrich R, Smith D
- Issue date: 2011 Jan 15
- Development and evaluation of an affordable real-time qualitative assay for determining HIV-1 virological failure in plasma and dried blood spots.
- Authors: Aitken SC, Kliphuis A, Bronze M, Wallis CL, Kityo C, Balinda S, Stevens W, Spieker N, de Oliveira T, Rinke de Wit TF, Schuurman R
- Issue date: 2013 Jun
- Dried blood spot specimens are a suitable alternative sample type for HIV-1 viral load measurement and drug resistance genotyping in patients receiving first-line antiretroviral therapy.
- Authors: Rottinghaus EK, Ugbena R, Diallo K, Bassey O, Azeez A, Devos J, Zhang G, Aberle-Grasse J, Nkengasong J, Yang C
- Issue date: 2012 Apr
- Field evaluation of dried blood spots for routine HIV-1 viral load and drug resistance monitoring in patients receiving antiretroviral therapy in Africa and Asia.
- Authors: Monleau M, Aghokeng AF, Eymard-Duvernay S, Dagnra A, Kania D, Ngo-Giang-Huong N, Touré-Kane C, Truong LX, Chaix ML, Delaporte E, Ayouba A, Peeters M, ANRS 12235 Study Group.
- Issue date: 2014 Feb