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Challenges and opportunities for the implementation of virological testing in resource-limited settings | Journal Article / Review | MSF Science Portal
Journal Article
|Review

Challenges and opportunities for the implementation of virological testing in resource-limited settings

Roberts TR, Bygrave H, Fajardo E, Ford NP
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Abstract
Though 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.

Countries

Botswana Brazil Kenya South Africa

Subject Area

diagnosticsmodels of careHIV/AIDS

Languages

English
DOI
10.7448/IAS.15.2.17324
Published Date
09 Oct 2012
PubMed ID
23078767
Journal
Journal of the International AIDS Society
Volume | Issue | Pages
Volume 15, Issue 2, Pages 17324
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