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Clin Microbiol Rev. 2019 May 15;32(3). pii: e00097-18. doi: 10.1128/CMR.00097-18. Print 2019 Jun 19.

Point-of-Care HIV Viral Load Testing: an Essential Tool for a Sustainable Global HIV/AIDS Response.

Author information

1
Department of Global Health, University of Washington, Seattle, Washington, USA pkdrain@uw.edu.
2
Department of Medicine, University of Washington, Seattle, Washington, USA.
3
Department of Epidemiology, University of Washington, Seattle, Washington, USA.
4
Centre for the AIDS Programme of Research in Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.
5
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
6
Department of Mechanical Engineering and Chemical Engineering, University of Washington, Seattle, Washington, USA.
7
PATH, Seattle, Washington, USA.
8
Foundation for Innovative New Diagnostics, Geneva, Switzerland.
9
Clinton Health Access Initiative, New York, New York, USA.
10
Institute for Disease Modeling, Seattle, Washington, USA.
11
Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.

Abstract

SUMMARYThe global public health community has set ambitious treatment targets to end the HIV/AIDS pandemic. With the notable absence of a cure, the goal of HIV treatment is to achieve sustained suppression of an HIV viral load, which allows for immunological recovery and reduces the risk of onward HIV transmission. Monitoring HIV viral load in people living with HIV is therefore central to maintaining effective individual antiretroviral therapy as well as monitoring progress toward achieving population targets for viral suppression. The capacity for laboratory-based HIV viral load testing has increased rapidly in low- and middle-income countries, but implementation of universal viral load monitoring is still hindered by several barriers and delays. New devices for point-of-care HIV viral load testing may be used near patients to improve HIV management by reducing the turnaround time for clinical test results. The implementation of near-patient testing using these new and emerging technologies may be an essential tool for ensuring a sustainable response that will ultimately enable an end to the HIV/AIDS pandemic. In this report, we review the current and emerging technology, the evidence for decentralized viral load monitoring by non-laboratory health care workers, and the additional considerations for expanding point-of-care HIV viral load testing.

KEYWORDS:

AIDS; HIV; differentiated care; point-of-care; viral load

PMID:
31092508
PMCID:
PMC6589862
[Available on 2020-05-15]
DOI:
10.1128/CMR.00097-18

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