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Improving laboratory efficiencies to scale-up HIV viral load testing.

George Alemnji1, Philip Onyebujoh, John N Nkengasong

  • 1aDivision of Global HIV and Tuberculosis, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia bState Department Office of the Global AIDS Coordinator and Health Diplomacy (S/GAC), Washington, D. C., USA cWorld Health Organization, Regional Office for Africa, Intercountry Support Team for East and Southern Africa, Harare, Zimbabwe.

Current Opinion in HIV and AIDS
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Summary

Scaling up viral load testing is crucial for HIV treatment success. Addressing inefficiencies in testing access, uptake, and result utilization is key to achieving viral suppression targets.

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Area of Science:

  • Virology
  • Public Health
  • Clinical Medicine

Background:

  • Viral load measurement is essential for monitoring HIV treatment efficacy and disease progression.
  • Global efforts aim to increase viral load testing to achieve 90% viral suppression in patients on antiretroviral therapy.

Purpose of the Study:

  • To review parameters for improving efficiencies in the viral load testing spectrum.
  • To enhance the utilization of viral load test results for patient management.

Main Methods:

  • This review synthesizes information on challenges and solutions across the viral load testing cascade.
  • Identifies key areas for intervention to improve testing efficiency and impact.

Main Results:

  • Scale-up initiatives face challenges including weak demand, supply chain issues, and poor data management.
  • Inefficiencies in specimen referral and laboratory-clinical interfaces hinder test result uptake.

Conclusions:

  • Addressing systemic inefficiencies across the viral load testing spectrum is critical for successful scale-up.
  • A renewed focus on access, uptake, and impact of viral load testing is needed to improve patient outcomes.