A Packaged Intervention to Improve Viral Load Monitoring within a Deeply Rural Health District of South Africa

Jaysingh Brijkumar,B A Johnson,K Pathan,H Sunpath,Y Zhao,J Edwards,S Pillay,K G Castro,P Moodley,M Y S Moosa,Vincent C Marconi,D K Kuritzkes

doi:10.2139/ssrn.3471345

Jaysingh Brijkumar, B A Johnson + Show 10 more

Open Access

https://doi.org/10.2139/ssrn.3471345

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Abstract

A Packaged Intervention to Improve Viral Load Monitoring within a Deeply Rural Health District of South Africa

Highlights

The KwaZulu-Natal (KZN) province of South Africa has the highest prevalence of human immunodeficiency virus (HIV) infection in the world
With a South African national goal to end the AIDS epidemic by 2030 and with the country adopting the 9090-90 United Nations Programme on HIV/AIDS (UNAIDS) goals where the third aim requires that 90% of all people on antiretroviral therapy (ART) achieve and maintain virologic suppression,[3] it is critical to optimize ART adherence for all patients in order to ensure this level of virologic suppression
Multiple research studies have validated the use of HIV-1 Viral load (VL) testing for monitoring ART response, determining prognosis,[4,5,6,7] and identifying early virological failure which may require ART changes

Summary

Introduction

The KwaZulu-Natal (KZN) province of South Africa has the highest prevalence of HIV infection in the world. Overall, according to United Nations Programme on HIV/AIDS (UNAIDS), the viral load (VL) suppression rate is 45% with 3·2 million of the 6·1 million people virologically suppressed. [1]The eastern coastal province of KwaZulu-Natal (KZN) experiences the highest burden of HIV infection in the country with 1·2 million people on treatment.[2] With the implementation of the national ‘universal test and treat’ programme, it is projected that nearly 6 million people nationally will be on treatment within the few years. With a South African national goal to end the AIDS epidemic by 2030 and with the country adopting the 9090-90 UNAIDS goals where the third aim requires that 90% of all people on ART achieve and maintain virologic suppression,[3] it is critical to optimize ART adherence for all patients in order to ensure this level of virologic suppression. Multiple research studies have validated the use of HIV-1 VL testing for monitoring ART response, determining prognosis,[4,5,6,7] and identifying early virological failure which may require ART changes. [8] VL monitoring is of critical national importance in the effort to halt HIV transmission, combat the emergence of HIV drug resistance, and decrease morbidity and mortality.[9, 10]

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