Bibliographic Info
GuidelineGuidelines: updated recommendations on HIV prevention, infant diagnosis, antiretroviral initiation and monitoring
Year of Publication2021
Issuing InstitutionWHO
Recommendation
Status
Maintained
Recommended in favor
Conditional
Certainty of evidence
Moderate
Point-of-care viral load may be used to monitor treatment among people living with HIV receiving ART
Notes and Remarks
- 1.First, point-of-care viral load technologies should be considered and used within the current treatment monitoring algorithm (Fig 1).2. Second, access to high-quality diagnostic testing should be continually expanded across HIV and other molecular testing needs, ideally combining laboratory-based and point-ofcare technologies in an integrated laboratory network. Additional procurement and optimal placement of point-of-care technologies should be considered within the context of the overall health system, including other disease programmes and needs. This will create efficiency and support expansion and improved diagnostic services for HIV and other diseases (TB, HIV viral load, etc.). In addition, strengthening integrated diagnostic systems may be considered to improve service and maintenance, specimen transport, training, quality assurance, mentorship and supervision, data systems, etc. However, conducting point-of-care viral load testing for all people living with HIV receiving ART may require significantly more volume than the testing capacity at most health-care facilities; robust and deliberate mapping and network optimization as well as setting priorities among patients should therefore be considered. A targeted testing or triaging approach may therefore be necessary (see Box 2). Testing pregnant and breastfeeding women with point-of-care technologies will enable more rapid clinical decision-making to prevent vertical transmission. Drug resistance rates are typically higher among infants, children and adolescents than among adults, and rapid results may thus prevent the selection of drug resistance mutations and preserve future treatment options, while preventing selection of drug resistance in the remaining high-risk populations is critical.
Also Featured In
This recommendation also appears in the following guidelines:
Guideline
Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach
Year2021
InstitutionWHO