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dc.contributor.authorRoberts, T
dc.contributor.authorCohn, J
dc.contributor.authorBonner, K
dc.contributor.authorHargreaves, S
dc.date.accessioned2017-03-31T19:03:39Z
dc.date.available2017-03-31T19:03:39Z
dc.date.issued2016-04-15
dc.identifier.citationScale-up of Routine Viral Load Testing in Resource-Poor Settings: Current and Future Implementation Challenges. 2016, 62 (8):1043-8 Clin. Infect. Dis.en
dc.identifier.issn1537-6591
dc.identifier.pmid26743094
dc.identifier.doi10.1093/cid/ciw001
dc.identifier.urihttp://hdl.handle.net/10144/618888
dc.description.abstractDespite immense progress in antiretroviral therapy (ART) scale-up, many people still lack access to basic standards of care, with our ability to meet the Joint United Nations Programme on HIV/AIDS 90-90-90 treatment targets for HIV/AIDS dependent on dramatic improvements in diagnostics. The World Health Organization recommends routine monitoring of ART effectiveness using viral load (VL) testing at 6 months and every 12 months, to monitor treatment adherence and minimize failure, and will publish its VL toolkit later this year. However, the cost and complexity of VL is preventing scale-up beyond developed countries and there is a lack of awareness among clinicians as to the long-term patient benefits and its role in prolonging the longevity of treatment programs. With developments in this diagnostic field rapidly evolving-including the recent improvements for accurately using dried blood spots and the imminent appearance to the market of point-of-care technologies offering decentralized diagnosis-we describe current barriers to VL testing in resource-limited settings. Effective scale-up can be achieved through health system and laboratory system strengthening and test price reductions, as well as tackling multiple programmatic and funding challenges.
dc.language.isoenen
dc.publisherOxford University Pressen
dc.rightsArchived with thanks to Clinical Infectious Diseases : an official publication of the Infectious Diseases Society of Americaen
dc.subjectviral loaden
dc.subject.meshAnti-HIV Agentsen
dc.subject.meshAntiretroviral Therapy, Highly Activeen
dc.subject.meshCD4 Lymphocyte Counten
dc.subject.meshDrug Monitoringen
dc.subject.meshHIV Infectionsen
dc.subject.meshHealth Plan Implementationen
dc.subject.meshHealth Resourcesen
dc.subject.meshHumansen
dc.subject.meshIndiaen
dc.subject.meshPoint-of-Care Systemsen
dc.subject.meshViral Loaden
dc.subject.meshWorld Health Organizationen
dc.titleScale-up of Routine Viral Load Testing in Resource-Poor Settings: Current and Future Implementation Challengesen
dc.identifier.journalClinical Infectious Diseases : an official publication of the Infectious Diseases Society of Americaen
refterms.dateFOA2019-03-04T13:20:01Z
html.description.abstractDespite immense progress in antiretroviral therapy (ART) scale-up, many people still lack access to basic standards of care, with our ability to meet the Joint United Nations Programme on HIV/AIDS 90-90-90 treatment targets for HIV/AIDS dependent on dramatic improvements in diagnostics. The World Health Organization recommends routine monitoring of ART effectiveness using viral load (VL) testing at 6 months and every 12 months, to monitor treatment adherence and minimize failure, and will publish its VL toolkit later this year. However, the cost and complexity of VL is preventing scale-up beyond developed countries and there is a lack of awareness among clinicians as to the long-term patient benefits and its role in prolonging the longevity of treatment programs. With developments in this diagnostic field rapidly evolving-including the recent improvements for accurately using dried blood spots and the imminent appearance to the market of point-of-care technologies offering decentralized diagnosis-we describe current barriers to VL testing in resource-limited settings. Effective scale-up can be achieved through health system and laboratory system strengthening and test price reductions, as well as tackling multiple programmatic and funding challenges.


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