viral load monitoring

The economies of scale of test and treat: A longitudinal costing study in Eswatini

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Author
Shaukat Khan, Cebele Wong, Pascal Geldsetzer, Gerda Asmus, Thomas How, Charlotte Lejeune, Velephi Okello, Till Bärnighausen

Swaziland has one of the highest adult HIV prevalence rates worldwide, 27%; with approximately 200,000 people 15 years and older living with HIV. Swaziland and many other countries in sub-Saharan Africa have adopted universal test-and-treat (UTT) policies. As the number of people needing and receiving ART in Swaziland is rapidly increasing, it is critical to understand the cost of UTT scale-up and its implications for the health system.

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HIV-1 viraemia and drug resistance amongst female sex workers in Soweto, South Africa: A cross sectional study

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Author
Coetzee J, Hunt G, Jaffer M, Otwombe K, Scott L, Bongwe A, Ledwaba J, Molema S, Jewkes R, Gray GE

HIV drug resistance (HIVDR) poses a threat to future antiretroviral therapy success. Monitoring HIVDR patterns is of particular importance in populations such as sex workers (SWs), where documented HIV prevalence is between 34-89%, and in countries with limited therapeutic options. Currently in South Africa, there is a dearth in evidence and no ongoing surveillance of HIVDR amongst sex work populations. This study aims to describe the prevalence of HIVDR amongst a sample of female sex workers (FSWs) from Soweto, South Africa.

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Pregnant and breastfeeding women: A priority population for HIV viral load monitoring

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Author
Landon Myer, Shaffiq Essajee, Laura N. Broyles, D. Heather Watts, Maia Lesosky, Wafaa M. El-Sadr, Elaine J. Abrams

With more than 18 million HIV-infected individuals having initiated antiretroviral therapy (ART) in low- and middle-income countries (LMICs) by the end of 2016, ensuring effective HIV care and treatment services is a global public health priority. Viral load (VL) quantification provides a direct measure of the effectiveness of ART, with a consistently elevated VL suggesting poor adherence or treatment failure and the need for intervention.

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Journey towards universal viral load monitoring in Maputo, Mozambique: many gaps, but encouraging signs

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Author
Swannet S, Decroo T, de Castro SMTL, Rose C, Giuliani R, Molfino L, Torrens AW, Macueia WSED, Perry S, Reid T

Viral load (VL) monitoring for people on antiretroviral therapy (ART) is extremely challenging in resource-limited settings. We assessed the VL testing scale-up in six Médecins Sans Frontières supported health centres in Maputo, Mozambique, during 2014-15.

This was the first study describing the uptake and results of VL testing scale-up in Mozambique. Identified gaps show patient and programmatic challenges. Where service delivery was customized to patient needs, VL monitoring was more successful.

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The virological durability of first-line ART among HIV-positive adult patients in resource limited settings without virological monitoring: a retrospective analysis of DART trial data

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Author
David I. Dolling, Ruth L. Goodall, Michael Chirara, James Hakim, Peter Nkurunziza, Paula Munderi, David Eram, Dinah Tumukunde, Moira J. Spyer, Charles F. Gilks, Pontiano Kaleebu, David T. Dunn, Deenan Pillay

Few low-income countries have virological monitoring widely available. We estimated the virological durability of first-line antiretroviral therapy (ART) after five years of follow-up among adult Ugandan and Zimbabwean patients in the DART study, in which virological assays were conducted retrospectively.

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Less frequent CD4 and viral load monitoring safe for people doing well on ART

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Author
Michael Carter

The frequency of routine monitoring for people treated with antiretrovirals with viral suppression can be safely reduced from every three months, to every six months, investigators from Europe and the United States report in the June 1st edition of the Journal of Acquired Immune Deficiency Syndromes. However, people followed-up every nine to twelve months were more likely to experience virologic failure and also had lower CD4 count increases compared to people monitored every three months.

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Targeted adherence measures and viral load monitoring needed to improve retention in South African ART programme

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Author
Lesley Odendal

Of the people living with HIV in South Africa who are eligible to start antiretroviral therapy (ART), only 57% are in care and only 37% of the 2012/2013 cohort of people receiving ART were given a viral load test, according to new results announced by the CEO of the South African National AIDS Council (SANAC) at the Southern African HIV Clinicians Society Conference held in Cape Town, South Africa, last month.

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Study shows prognostic value of viral load monitoring among people living with subtype C HIV in South Africa

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Author
Michael Carter

Viral load is the single most important predictor of CD4 cell loss among people in South Africa who had not started HIV treatment, investigators report in PLOS ONE. All the study participants were living with HIV subtype C. The annual decline in CD4 count was approximately 11% for people with a baseline viral load below 10,000 copies/ml, compared to a 14% loss for people with a baseline viral load above 100,000 copies/ml.

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