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Scale-up of Routine Viral Load Testing in Resource-Poor Settings: Current and Future Implementation Challenges | Journal Article / Research | MSF Science Portal
Journal Article
|Research

Scale-up of Routine Viral Load Testing in Resource-Poor Settings: Current and Future Implementation Challenges

Roberts TR, Cohn J, Bonner K, Hargreaves S
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Abstract
Despite 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.

Subject Area

HIV/AIDS

Languages

English
DOI
10.1093/cid/ciw001
Published Date
06 Jan 2016
PubMed ID
26743094
Journal
Clinical Infectious Diseases
Volume | Issue | Pages
Volume 62, Issue 8
Issue Date
2016-01-06
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