HIV-1 viral load testing in resource-limited settings: Challenges and solutions for specimen integrity
Howard Newman1,2,3, Diana Hardie1,4
1National Health Laboratory Service, South Africa.
Reviews in Medical Virology
|September 26, 2020
Summary
HIV-1 viral load testing is essential for antiretroviral therapy monitoring. Innovative solutions like dried blood spots and point-of-care tests can overcome challenges in resource-limited settings for better HIV monitoring.
Area of Science:
- Virology
- Public Health
- Clinical Diagnostics
Background:
- HIV-1 viral load (VL) testing is critical for monitoring antiretroviral therapy (ART).
- The effectiveness of ART programs relies heavily on the accessibility and quality of VL testing services.
- Pre-analytic factors significantly impact VL testing accuracy, with specimen integrity often compromised in resource-limited settings.
Purpose of the Study:
- To review the challenges associated with HIV-1 VL testing in resource-limited settings.
- To explore innovative solutions for overcoming barriers to widespread VL monitoring.
- To highlight the importance of specimen integrity in VL testing.
Main Methods:
- Literature review of challenges and solutions in HIV-1 VL testing.
- Analysis of pre-analytic factors affecting VL test quality.
- Examination of alternative specimen types and testing platforms.
Main Results:
- Resource-limited settings face significant logistic and financial challenges affecting VL testing.
- Specimen integrity is frequently compromised, limiting access to VL monitoring.
- Innovative approaches such as dried blood spots, dried plasma spots, plasma separation cards, and point-of-care tests offer viable solutions.
Conclusions:
- Despite challenges, widespread HIV-1 VL testing is achievable in resource-limited settings.
- Alternative specimen types and point-of-care technologies can enhance access to VL monitoring.
- Continued innovation is key to improving ART program effectiveness globally.
