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Genotypic Inference of HIV-1 Tropism Using Population-based Sequencing of V3

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Published on: December 27, 2010

Targeting the third '90': introducing the viral load champion.

H Sunpath^1,2, T J Hatlen³, K K Naidu⁴

¹Centre for Aids Program of Research, University of Kwa Zulu-Natal, Durban, South Africa.

Public Health Action

|February 19, 2019

Summary

Implementing a viral load (VL) champion program significantly improved VL testing rates, exceeding 90% in all clinics. This quality improvement initiative supports the UNAIDS 90-90-90 goals for HIV treatment.

Keywords:

AIDS HIV South Africa clinical champion

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Area of Science:

Public Health
Infectious Disease Management
HIV/AIDS Research

Background:

The UNAIDS 90-90-90 targets aim to improve HIV/AIDS outcomes.
Effective viral load (VL) monitoring is crucial for recognizing treatment failure and achieving treatment goals.
Previous VL monitoring strategies may require enhancement to meet global targets.

Purpose of the Study:

To assess the impact of a viral load champion (VLC) program on VL monitoring.
To improve VL completion rates and contribute to the third UNAIDS 90-90-90 target.
To evaluate a quality improvement intervention for HIV patient management.

Main Methods:

A prospective, pre- and post-intervention study was conducted across three clinics in eThekwini, Kwa-Zulu Natal.
A viral load champion (VLC) was assigned to each clinic to enhance VL monitoring.
Descriptive analysis (chart audit) compared VL completion rates before and after the intervention.

Main Results:

Pre-implementation VL completion rates were below target across all sites (ranging from 54% to 68%).
Post-intervention, VL completion rates significantly increased at 6 months (83% to 99%) and remained high at 12 months (>90%).
The intervention demonstrated a statistically significant improvement (P < 0.0001) in VL completion rates at all study sites.

Conclusions:

A clinic-level viral load champion program is an effective quality improvement intervention.
This multifaceted approach significantly enhances viral load monitoring and supports progress towards UNAIDS targets.
Scaling up the VLC program has substantial implications for achieving the third UNAIDS 90-90-90 goal.