Viral Load Monitoring Research Articles

Human Papillomavirus Genotype Distribution and Viral Load in Relation to Cervical Disease Severity: A Retrospective Study of Outpatient Data in Beijing, China.

Persistent human papillomavirus (HPV) infection drives cervical carcinogenesis, yet regional variations in genotype distribution and viral load dynamics remain understudied in Beijing, China. This study investigated HPV prevalence, genotype-specific patterns, and viral load correlations with cervical disease severity among women outpatient clinics from Peking University First Hospital in Beijing. In a retrospective study of 25 197 women undergoing cervical ThinPrep cytology (TCT) and HPV testing from October 2023 to October 2024, colposcopy results from 714 cases were also analyzed. HPV genotyping and quantitative for HPV types (16, 18, 33, 52, 58) were performed. Overall HPV positivity was 16.50% (4157/25 197), peaking in women aged 31~40 years (30.05%). Dominant genotypes were HPV 52 (18.89%), 16 (18.55%), and 58 (12.10%). HR-HPV prevalence and viral load escalated with disease severity (p < 0.001), notably HPV16 and HPV33. HPV11, 43, 45, and 68 were absent in severe lesions. Single infections (76.35%) predominated, but multi-infections showed genotype synergism (e.g., HPV51 + 42). The study highlights specific HPV epidemiology and genotype dominance in China, indicating gaps in vaccine coverage. Viral load is a key biomarker for risk assessment, suggesting the need for tailored vaccination programs and viral load monitoring in clinical practice.

'I was like, this is gonna hurt': Implementing self-sampling of dried blood spots to measure HIV viral load.

Sexual minority men (SMM) with HIV who use stimulants may experience greater difficulties with antiretroviral therapy adherence which amplifies risk for unsuppressed HIV viral load (VL). Remote monitoring of VL could support efforts to rapidly respond to sub-optimal adherence. This qualitative study enrolled 24 SMM with HIV who use stimulants to examine experiences with two different dried blood spots (DBS) self-sampling devices (i.e., Tasso-M20 vs. HemaSpot HD) to measure VL. Participants were asked to complete self-sampling of DBS using both devices, and then participated in a 45-minute semi-structured interview. Interviews focused on ease of use, device preference, experiences with receiving and mailing kits, and barriers to participating in research. A thematic analysis was conducted to analyze interview transcripts. Twenty-two participants (92%) returned the Tasso-M20 and 21 (88%) returned the Hemaspot HD devices. Among the 22 participants that completed qualitative interviews, twenty-three codes were identified and collapsed within seven themes. Preferences for devices were based on convenience, pain and prior experiences with finger-pricking technology. Participants emphasized that clearer instructions with contingency plans for self-sampling of DBS would improve the user experience with self-sampling of DBS. Intersectional stigma (e.g., HIV, sexual minority status, and substance use) was noted as an important consideration in implementing self-sampling of DBS. Promoting decision making, or the option to choose sampling method based on personal preferences, may improve engagement and likelihood of DBS completion. Findings will guide the broader implementation of self-sampling of DBS to optimize VL monitoring in SMM with HIV who use stimulants. Routine HIV viral load (VL) testing is recommended to assess the success of anti-retroviral therapy (ART) and identify individuals who may be experiencing difficulties with adherence to optimize rates of viral suppression [1]. The U.S. Department of Health and Human Services (HHS) Panel on Antiretroviral Guidelines for Adults and Adolescents recommends routine VL monitoring every three to six months after initiating ART. For those with optimal ART adherence and consistently suppressed VL for more than one year, VL monitoring is recommended every six months [2]. A convenience sample of SMM with HIV who use stimulants were recruited via email using an existing consent-to-contact database of individuals interested in potential research participation. Recruitment included up to three emails, sent between March and June 2022, which detailed the study purpose and provided a link to the online study screener. Interested individuals who clicked on the provided link were directed to a brief screener consent page before reaching the screener survey. Eligible individuals were a) cisgender man, b) aged 18 or older, c) comfortable reading and speaking English, d) US residency, e) reported ever having anal sex with a man, f) self-reported HIV diagnosis at least 90 days prior to screening, g) an active ART prescription AND < 90% past-month adherence on the 3-item Wilson measure in the past 30 days [21], h) screened positive for a moderate or severe stimulant use disorder (i.e., cocaine or methamphetamine) in the past 3 months with an abbreviated version of the National Institute on Drug Abuse (NIDA)-modified Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) [22], and i) ownership of an iPhone or Android smartphone. Individuals who met the eligibility criteria were contacted by study staff to schedule a Zoom assessment, where they received information about the study, completed informed consent, and provided contact information so that self-sampling DBS collection devices could be mailed to their homes.

Examining and classifying reasons for missing viral loads among adults living with HIV: An extended outcome investigation and ascertainment approach in Western Kenya.

Gaps in HIV RNA monitoring persist globally impeding the ability to determine clinical progress and outcomes. This study systematically evaluated provider (e.g., guideline non-adherence), system (e.g., laboratory error) and participant-level (e.g., refusal) drivers of missed viral load (VL) monitoring measurements among people with HIV in Kenya. Adults aged 18-65 years were followed across five health facilities in Kenya as part of a clinical trial (NCT#02338739) where HIV RNA monitoring was done routinely. Instances of missed VL despite being indicated per Kenyan guidelines were identified. An algorithm for assessing root causes of missing HIV RNA was developed and generalized linear models estimated the risk ratios (RR) for participant-level characteristics associated with missed viral load. Among 1,754 participants (66% female), the prevalence of missed viral load in year one and two was 24.4% and 29.4%, respectively. Drivers for missed viral load measurements included loss to follow up (51.5% in year one and 57.8% in year two), clinician non-adherence with guidelines (36.7% in year one and 32.2% in year two), unknown (10.3% in year one and 8.6% in year two), and requested but not collected (1.5% in year one and 1.3% in year two). Participants aged < 24 years (RR 2.27, 95% CI: 1.66-3.12), those with higher socioeconomic status (RR 1.47, 95% CI: 1.03-1.91), receiving HIV treatment at a rural clinic (RR 1.22, 95% CI: 1.02-1.46) and with advanced HIV disease (RR 2.39, 95% CI: 1.52-3.73) were more likely to miss VL monitoring. Missed routine viral load monitoring remains high, primarily due to loss to follow-up, and may substantially alter suppression estimates. Sustainable approaches to keep people with HIV engaged in care, alongside strengthening providers' clinical practices and alignment with national guidelines, are necessary for optimizing viral monitoring and accurately assessing viral suppression within public health systems.

A Bioluminescent Imaging Mouse Model for Seasonal Influenza Virus Infection Based on a Pseudovirus System.

Influenza (flu) is a highly prevalent respiratory illness caused by influenza viruses, representing a significant global health burden due to its substantial morbidity and mortality rate. Vaccination remains the most effective strategy for influenza prevention, and well-characterized animal models of influenza infection serve as essential tools for evaluating vaccine protective efficacy. However, animal models utilizing live influenza virus strains pose significant biosafety concerns, and many such strains are not readily available for research. To address these challenges, we established a novel visual mouse infection model using an HIV-based vector system. This model employs influenza pseudoviruses carrying a luciferase reporter gene, enabling real-time monitoring of viral load and in vivo tracking of viral distribution during infection. Using this infection model, we assessed the in vivo protective efficacy of an influenza vaccine and cross-validated the pseudovirus-based evaluation results against a live virus-infected mouse model. Our study thus establishes a safer and more convenient platform for evaluating influenza vaccine efficacy, including the assessment of broad-spectrum neutralization capacity.

Viral suppression after failure of PI-based ART among adolescents and youths with and without drug resistance mutations: a longitudinal analysis in Tanzania.

People living with HIV (PLHIV) who fail first-line ART have a higher risk of failing subsequent ART. We examined viral suppression (VS) among adolescents and youths (AY) failing PI ART in Tanzania. We conducted a retrospective study nested within a national third-line cohort of PLHIV. We analysed data of 147 AY (aged 10-24 years) with failure of PI-based ART between 2020 and 2022 who were followed for 12 months to assess for VS. Descriptive statistics were summarized by demographics and clinical characteristics, and we used logistic regression to assess factors associated with virological failure (VF) and drug resistance mutations (DRMs). More than 40% of 147 participants had HIV subtype A, 52% (76/147) harboured major PI DRMs and 35% had NRTI mutations. A PI regimen at ART initiation was associated with a major PI DRM adjusted relative risk (aRR) of 1.66 (95% CI: 1.13-2.44; P = 0.010). Among participants with major PI DRMs, 12.2% had intermediate to high levels of resistance to lopinavir and atazanavir, and 2.1% to darunavir, respectively. V82A was the most frequent PI DRM; NRTI mutations included thymidine analogue mutations and absent K65R. VS occurred in 65% of AY who had PI DRMs compared with 45% of those without DRMs; this difference was not statistically significant. More than half of AY who had PI DRMs had a higher proportion of early VS (65%) compared with those without DRMs (45%). Optimal viral load monitoring, adherence intensification and routine drug resistance testing are key strategies to improve VS.

WED-310 A mathematical viral load model characterises the exposure- response relationship between bulevirtide and hepatitis delta virus and identifies the minimum duration of on-treatment viral load monitoring required for accurate prediction of long-term virologic response

WED-310 A mathematical viral load model characterises the exposure- response relationship between bulevirtide and hepatitis delta virus and identifies the minimum duration of on-treatment viral load monitoring required for accurate prediction of long-term virologic response

Incidence and Timing of Epstein-Barr Virus Whole Blood DNAemia in Epstein-Barr Virus-Mismatched Adult and Pediatric Solid Organ Transplant Recipients.

Epstein-Barr virus (EBV) viral load (VL) monitoring is recommended post-transplant for EBV-mismatched (donor EBV seropositive/recipient EBV seronegative) solid organ transplant (SOT) recipients as a component of post-transplant lymphoproliferative disorder (PTLD) prevention, but the optimal frequency and timing of EBV VL monitoring remains unknown. In this retrospective cohort study, we investigated the incidence and timing of whole blood EBV DNAemia in EBV-mismatched adult and pediatric SOT recipients, who had EBV VL monitoring as part of a pre-emptive approach to PTLD prevention to optimize monitoring algorithms. We explored associations between donor-acquired EBV DNAemia (DA-EBV), defined as EBV DNAemia within 1year post-transplant, and donor and recipient characteristics, and determined the proportion who developed PTLD. We analyzed 257 D+/R- recipients (kidney n = 64, heart n = 75, liver n = 93, lung n = 25); 126/257 (49.0%) developed DA-EBV at a median of 83days (Q1-Q3: 50-130days) post-transplant. Incidence of DA-EBV varied by organ and was highest in liver (62.4%) and lowest in heart recipients (28.0%). PTLD was diagnosed in 38/257 (14.8%) EBV-mismatched recipients, 25/162 (15.4%) children, and 13/95 (13.7%) adults. DA-EBV was uncommon in recipients less than 6months old (3/29, 10.3%) and among recipients less than 12months with donors less than 12months (2/29, 6.9%); possible mechanisms of protection other than recipient passive maternal antibody and false-positive donor serostatus are discussed. Monitoring for DA-EBV should be focused on months 2-6 post-transplant. Less frequent whole blood EBV VL monitoring is likely a safe option in recipients less than 6months old and recipients 6-12months old with donors less than 12months old.

Implementation of pooled testing to increase access to routine viral load monitoring for people living with HIV on antiretroviral therapy

For the 30 million people living with HIV on antiretroviral therapy, routine viral load testing is recommended to monitor treatment effectiveness. However, only an estimated 77% of eligible people accessed viral load testing in 2022, due to barriers including the high costs of tests. Here we assessed implementation of pooled testing to increase viral load testing efficiency at a reference laboratory in Cameroon. Plasma specimens were tested in pools of three using the Abbott RealTime HIV-1 Viral Load assay. For pools with HIV-1 detected, each specimen was then tested and reported individually; for the negative pools, the pooled result was reported with no further testing. From July to December 2023, results for 12,396 specimens tested in pools were produced using 6,797 assays, or 0.55 assays per result, with 3.6% (449) reported as unsuppressed (> 1,000 copies/mL), enabling an additional 5,409 people (+ 80%) to have test results. When testing pools of three, the limit of detection per specimen increases from < 40 copies/mL to < 120 copies/mL, with only an estimated 0.01% of specimens with results of ≥ 1,001 copies/mL (unsuppressed) having results misclassified as suppressed. These results demonstrate that pooled testing can be an efficient and accurate approach to increase access to viral load monitoring.

Evaluation of the Use of Plasma Preparation Tubes for HIV Viral Load Testing in Nigeria.

Routine viral load (VL) monitoring of persons living with HIV (PLWH) on antiretroviral therapy (ART) is imperative for improving the long-term success of treatment. Due to a limited number of PCR laboratories, VL testing is centralized, requiring cold chain storage while transporting samples from remote healthcare centers to referral PCR laboratories, which is a major challenge. The Becton Dickinson (BD) Vacutainer® Plasma Preparation Tube (PPT) was designed to mitigate cold chain transport needs and secondary tube storage of plasma. This cross-sectional study assessed the suitability of PPTs for sample transportation in remote settings, in place of EDTA non-gel Vacutainers, eliminating the need for cold chain storage. Venous blood was collected from 115 PLWH into 3 Vacutainer tubes (1 EDTA and 2 PPT). The plasma obtained from the first PPT was assayed for HIV VL along with the plasma obtained from EDTA non-gel Vacutainer within 6 h on the COBAS 6800 (Roche Diagnostics) instrument. Samples from the second PPT were stored at room temperature (20 to 28°C) for 24 h before testing on the same instrument. The Wilcoxon signed rank test and W statistic (P value 0.91) showed that VL results obtained from the EDTA were comparable to the PPT on the collection day, and after 24 h at room temperature. Sensitivity and specificity for same-day and 24-hour testing were both 100%. The BD Vacutainer PPT was shown to have similar VL results to the EDTA non-gel Vacutainer, and can therefore be deployed to remote settings for sample collection and transportation to PCR referral laboratories.

Clinical features of HAdV-55 in children with respiratory tract infections: a retrospective case series and literature review

BackgroundHuman adenovirus type 55 (HAdV-55) can lead to acute respiratory diseases, significant morbidity, and mortality in children.MethodsHospitalized children diagnosed with HAdV-55 between September 2016 and March 2024 at the Children’s Hospital of Chongqing Medical University were retrospectively analyzed. HAdV-55 was detected through polymerase chain reaction and sequencing. Clinical data were collected, including demographic characteristics, clinical manifestations, laboratory findings, imaging results, treatment history, and prognosis. A literature search was conducted using the PubMed database and China National Knowledge Infrastructure from their inception to June 2024. Search terms included “HAdV-55”, “HAdV-11a”, “adenovirus type 55” and their derivatives. Clinical features were evaluated in conjunction with literature on HAdV-55 infections in children.ResultsFive children with HAdV-55 infection were identified, including one mild, two severe, and two critical. The two critical patients exhibited progressive declines in total blood cell counts, hemoglobin levels and serum albumin levels within a short period. Adenoviral DNA was detected in pleural fluid or serum for them. They received mechanical ventilation, intravenous immunoglobulin, Methylprednisolone, blood transfusions, and antibiotics, while died for acute respiratory distress syndrome (ARDS). The remaining ones recovered and were discharged with good prognosis. A review of 56 cases, including those from this study, revealed that 61.9% (26/42) of infections were classified as severe or critical, with a mortality rate of 16.4% (9/55). Sequelae included bronchiolitis obliterans and bronchiectasis.ConclusionsThe genetic inheritance of HAdV-55 remained stable, with an upward trend of HAdV-55 severe infection among children from 2000 to 2019. Early clinical symptoms of HAdV-55 infection were overlapped with other respiratory viral infections. Rapid declines in blood cell counts, hemoglobin levels and serum albumin, along with dynamic monitoring of viral loads in sterile fluids, may serve as prognostic indicators.

Prevalence and predictors of virological failure among the people living with HIV on antiretroviral treatment in East Africa: evidence from a systematic review with meta-analysis and meta-regression of published studies from 2016 to 2023

Background Virological failure (VF) significantly threatens the efficacy of antiretroviral therapy (ART) programs in East Africa. This systematic review and meta-analysis assess the prevalence and predictors of VF among individuals living with HIV. Methods We searched PubMed, Web of Science, African Journals Online, and EMBASE for relevant studies. Heterogeneity was assessed using the I 2 statistic, and random-effects models addressed between-study variability. Publication bias was examined through funnel plots, Egger’s regression, and Begg’s tests. Subgroup analyses and meta-regression explored heterogeneity sources and potential VF predictors. Analyses were conducted using MedCalc version 20.010, adhering to PRISMA 2020 guidelines. Results Twenty-five records were included, with a sample size of 29,829 people living with HIV on ART. The pooled prevalence of VF in East Africa was 19.4% (95% CI: 15.2%–24.0%), with substantial heterogeneity across studies. Sociodemographic predictors of VF included male sex (30.9%, p < .001), unmarried status (28.2%, p < .001), lower educational attainment (33.0%, p < .001), non-formal employment (47.2%, p < .001), and urban residence (51.2%, p < .001). Clinical factors associated with higher VF rates were ambulatory status (44.7%, p < .001), low CD4 count (35.1%, p < .001), low haemoglobin (52.2%, p < .001), advanced HIV stage III/IV (44.2%, p < .001), HIV/TB co-infection (24.3%, p < .001), and other opportunistic infections (20.5%, p = .008). Treatment-related factors associated with VF were first-line nevirapine-based regimen (27.7%, p = .009) and poor ART adherence (41.76%, p < .001). Conclusion Sociodemographic factors, advanced HIV disease, co-morbidities, poor adherence, and specific first-line ART regimens are key predictors of virological failure. Targeted, multidisciplinary interventions focusing on routine viral load monitoring, adherence support, and addressing socioeconomic barriers are essential to improve ART outcomes in East Africa.

Modeling the potential impact of viral load monitoring on vertical transmission of HIV in Kenya.

Viral load (VL) monitoring among pregnant and breastfeeding women (PBFW) can reduce vertical transmission (VT) by identifying PBFW with unsuppressed VL and promoting re-suppression. However, the impact of varying degrees of adherence to VL monitoring guidelines on the prevention of vertical transmission (PVT) is unknown. We developed a microsimulation model of HIV progression and PVT care for PBFW living with recently acquired HIV in Kenya. We used this model to evaluate VL monitoring in two key maternal populations: 1) newly positive (NP) pregnant women who initiate ART during antenatal care and 2) known positive (KP) women who are diagnosed and initiate ART prior to conception. For each population, we simulated three levels of adherence to Kenyan VL monitoring guidelines during pregnancy and 18 months of breastfeeding: 1) No testing (NT); 2) 50% adherence to indicated VL tests (VL-50%); 3) 100% adherence (VL-100%). We evaluated VL monitoring in each population by comparing live births, maternal deaths, and VT under VL-50% and VL-100% to NT. Under NT, infants acquired HIV at a rate of 619 vs. 505 per 10,000 live births in the NP vs. KP populations, respectively. VL monitoring reduced VT by 1.6-2.7% in NP women vs. 9.1%-14.3% in KP women, and it reduced maternal deaths by 1.2-1.8% vs. 1.6-2.3%. Maternal VL monitoring in Kenya has considerably greater potential for achieving relative reductions in VT among KP women than among NP women. In KP women, even imperfect adherence to guidelines may achieve substantial relative reductions in VT.

HIV Viral Rebound on Dolutegravir, Lopinavir and Efavirenz: National Program Data Analysis from Ukraine

Background: Dolutegravir (DTG), an integrase strand transfer inhibitor, is recommended as the preferred first-line HIV medication globally due to higher efficacy, better tolerability, and higher genetic barrier to resistance compared to other antiretroviral therapy (ART) drug classes. However, little is known about the comparative effectiveness of DTG in sustaining durable viral suppression (VS) in real-world settings. Methods: We analyzed data from electronic health records of a retrospective cohort of ART-naïve (N=3793) and ART-experienced (N=14367) people receiving HIV treatment in Ukraine between October 2017 – September 2018, comparing incidence of viral rebound (viral load 200 HIV RNA copies/ml) after the first documented VS among participants on DTG-, ritonavir-boosted lopinavir (LPV/r)-, and efavirenz (EFV)-based regimens. Participants were followed until June 2019. Interval censoring survival analysis with cluster-robust standard errors was used to estimate the effects of ART regimen on viral rebound adjusting for demographic and clinical characteristics. Results: N=714 (3.9%) participants experienced viral rebound during follow-up. In the ART-naïve cohort, the incidence of rebound was 6.9 events (95%CI: 5.9–8.0) per 100 person-years. LPV/r-based regimens were associated with higher hazard of rebound compared to DTG-based regimens: aHR=1.8 (95%CI: 1.3–2.4). EFV-based regimens had similar incidence of rebound compared to DTG: aHR=1.1 (95%CI: 0.9–1.3). Conclusion: Favorable performance of DTG compared to other first-line ART options in sustaining VS supports continued roll-out of DTG-based regimens. High overall incidence of viral rebound, including on DTG-based regimens, calls for targeted evidence-based adherence support interventions and improved viral load and drug resistance monitoring, especially among high-risk populations.

ViraLite: An Ultracompact HIV Viral Load Self-Testing System with Internal Quality Control.

The availability of effective antiretroviral therapy has made HIV manageable, provided patients have consistent access to routine viral load (VL) testing. Nonetheless, access to frequent VL testing remains limited. There is a need for accessible, user-friendly testing systems that allow people living with HIV (PLHIV) to monitor their VL more frequently and empower self-management. Here, we developed ViraLite, a sample-to-answer, compact, accessible, and battery-powered system for HIV viral load monitoring. The system is built upon a probe-based RT-LAMP assay that allows for multiplexed detection and quantification. An internal quality control targeting the RNase P was incorporated to enhance the reliability of the results. A software-reconfigurable real-time sensing system empowered by machine learning and a smartphone-guided protocol was developed in tandem to analyze the multiplexed assay. We analyzed 45 clinically archived samples using ViraLite and benchmarked our results against qRT-PCR, which showed 21 positive and 23 negative samples. Using our process control, ViraLite first identified 17 inconclusive samples that would otherwise be classified as negative. Then, ViraLite classified 14 out of 15 HIV-positive samples (93.3%) and 13 out of 13 HIV-negative samples (100%). The incorporation of RNase P as a process control increased the sensitivity of ViraLite from 66.66% to 93.33%, while maintaining a high specificity (100%). To assess the acceptance of ViraLite among PLHIV, we recruited 480 participants from online and three clinical sites to complete a survey. Over 86% of participants indicated ViraLite had benefits in convenience and privacy, on the other hand 61% of participants indicated concerns with test accuracy. The integration of compact hardware, a reliable assay, and smartphone guidance provides an accurate, easy to use system for PLHIV to self-manage their viral load and update their prescriptions frequently.

Development and evaluation of the digital PCR-based method for clinical monitoring of viral loads during severe fever with thrombocytopenia syndrome virus infection.

Development and evaluation of the digital PCR-based method for clinical monitoring of viral loads during severe fever with thrombocytopenia syndrome virus infection.

Evaluating a novel quantitative assay for HIV-1 VL among Chinese individuals infected with HIV.

Evaluating a novel quantitative assay for HIV-1 VL among Chinese individuals infected with HIV.

Uptake and timing of viral load testing and frequency of viraemic episodes during pregnancy in South Africa.

Repeated monitoring of viral load (VL) among pregnant women living with HIV (WLWH) is critical in vertical transmission prevention. For women who are newly diagnosed with HIV during pregnancy, a subsequent VL is recommended three months after ART initiation, and for all women living with HIV, follow-up VL is required every six months throughout pregnancy and breastfeeding [2]. Here, we describe the uptake and timing of VL testing and frequency and distribution of viraemic episodes during pregnancy. We linked prospective cohort data from WLWH whose infants were born at Rahima Moosa Mother and Child Hospital (RMMCH) in Johannesburg, South Africa (2013-2018) to laboratory data from the National Health Laboratory Services national HIV cohort. We report the uptake and timing of VL testing, and frequency of viremia and viral suppression. We also explore factors associated with having at least one or more VL test. Data from 4,064 women with known dates of entry into antenatal care and delivery during the study period were analysed. Overall, less than half (46%) completed VL testing during pregnancy. Most VL were conducted during the third trimester (67%). Only 5% (n=100) were during the first trimester and 11% within 7 days of delivery. Three-quarters of tests during pregnancy indicated viral suppression (VL <400 copies/mL), 7% viraemic (VL 400-1000 copies/mL), and 19% high grade viraemia (VL >1000 copies/mL). We found that being older (≥35) and being engaged in HIV care prior to pregnancy were significantly associated with VL testing during pregnancy. With less than half of pregnant women living with HIV in this study having a VL measure during their pregnancy, and VL testing occurring late in pregnancy, this study highlights critical gaps in providing quality HIV care to women and prevention of vertical transmission.

Comparative evaluation of plasma and serum HIV-1 viral load measurements among HIV positive individuals, Northwest Ethiopia: Analytical cross-sectional study.

Plasma HIV viral load tests have been widely used in clinical practice to monitor treatment success or failure. Inappropriate mixing with anticoagulants and inaccessibility of plasma samples in certain clinical services (such as antenatal care services) might hinder HIV diagnosis and treatment services. Considering that serum has higher stability and availability in prenatal care services, periodic monitoring of serum HIV viral load might be an alternative approach. Thus, this study aimed to evaluate the plasma and serum HIV-1 viral load measurements among HIV-positive individuals in Northwest Ethiopia. An institution-based analytical cross-sectional study was conducted on 74 paired plasma and serum samples from May to August 2020 at the HIV Treatment Center, Northwest Ethiopia. Four milliliters of paired venous blood were collected to harvest plasma and serum. HIV-1 RNA was extracted and quantified using the Roche COBAS AmpliPrep/COBAS TaqMan assay. Data were analyzed using SPSS version 20. Paired sample t-tests and Pearson's correlation were employed to observe the mean differences and associations between sample measurements, respectively. Bland-Altman and linear regression models were computed to demonstrate the level of agreement and proportional bias, respectively. A p-value of ≤ 0.05 with a 95% confidence interval was considered statistically significant. From a total of 74 HIV-positive individuals, 49 (66.2%) were females. The mean ± SD age was 36.3 (10.1) years. The mean difference ± SD of plasma and serum HIV-1 viral load was 0.07 ± 0.75 log copies/mL, (p = 0.428). A strong association with a significant linear correlation (r = 0.862) (p < 0.001) and a high level of agreement were observed between the sample measurements using Pearson's correlation and a Bland-Altman plot, respectively. The current study highlights an alternative application of serum-based HIV viral load quantification to enhance the rate of HIV diagnosis and treatment monitoring coverage.

Transmission of Dolutegravir resistance in treatment-naive individuals with HIV-1: A cohort study.

Transmission of Dolutegravir resistance in treatment-naive individuals with HIV-1: A cohort study.

Level of non-adherence and associated factors among children on antiretroviral therapy in public hospitals of South Wollo Zone, Northeast Ethiopia.

Poor adherence to antiretroviral therapy (ART) occurs when an individual with Human Immune deficiency Virus does not follow the prescribed treatment regimen correctly. This includes missing doses, not taking medication as scheduled, taking medication inconsistently or irregularly, and failing to adhere to specific instructions. The lack of adherence to antiretroviral therapy (ART) among children is a noteworthy issue that necessitates attention. The study aims to determine the level of non-adherence to antiretroviral therapy (ART) and its associated factors in children receiving ART in public hospitals in the South Wollo Zone. A multi-center cross-sectional study was conducted among children receiving antiretroviral therapy at South Wollo Zone public hospitals. A single population proportion formula was used to determine the required sample size. A computer-generated simple random sampling method was employed to select the participants. The tools used to assess adherence for all participants were viral load monitoring, Self-reporting, Pill counts, and Pharmacy refill records. Data were collected through face-to-face interviews, and reviewing patients' documents using a structured checklist. The data were entered into Epi Data version 4.1 and analyzed using STATA 17. Binary logistic regression was employed to evaluate the relationship between the factors and the outcome variable. Variables were considered significant if the p-value was less than 0.05. Of 291 participants, 286 were involved in the study, making the response rate 98.3%. The mean age of the participants was 7.8 years old (±3.64 SD), and half of the 146 children (51%) were male. The overall proportion of ART non-adherence was 24.1% (95% CI: 19.2-29.0%). Positive TB status (Adjusted odd ratio (AOR) = 4.10, 95% CI: 1.90-8.88), diagnostic status not disclosed (AOR = 2.69, 95% CI: 1.43-5.00), and poor caregiver knowledge (AOR = 2.18, 95% CI: 1.04-4.56) were significantly associated with poor adherence. According to the current study, the level of non-adherence to antiretroviral therapy remains high compared to the targets set by the United Nations Joint Program on HIV/AIDS (UNAIDS) Project 95-95-95. TB co-infection, undisclosed diagnostic status, and poor caregiver knowledge were found to be significantly associated with non-adherence. Before and throughout ART, healthcare providers should provide intense and ongoing counseling to children and their caregivers.