Research Article: The missed potential of CD4 and viral load testing to improve clinical outcomes for people living with HIV in lower-resource settings

Date Published: May 29, 2019

Publisher: Public Library of Science

Author(s): Peter D. Ehrenkranz, Solange L. Baptiste, Helen Bygrave, Tom Ellman, Naoko Doi, Anna Grimsrud, Andreas Jahn, Thokozani Kalua, Rose Kolola Nyirenda, Michael O. Odo, Pascale Ondoa, Lara Vojnov, Charles B. Holmes

Abstract: In a Policy Forum, Peter Ehrenkranz and colleagues discuss the contribution of CD4 and viral load testing to outcomes for people with HIV in low- and middle-income countries.

Partial Text: CD4 and viral load (VL) testing have long been recognized as integral to the management of HIV disease [1,2]. However, recent shifts in the global HIV response have driven rapid changes in the prioritization and use of these tests. Perhaps most critical, the World Health Organization (WHO)’s 2016 recommendation to treat all people diagnosed with HIV regardless of immune status led to the loss of one of the primary indications for CD4 testing [1]. In addition, the perceived value and feasibility of VL testing has risen rapidly, driven by decreasing costs of VL testing [3], WHO’s 2013 recommendation encouraging use of VL over CD4 for routine monitoring [4], and by the 2014 Joint United Nations Programme on HIV/AIDS 90–90–90 campaign [5]. The “third 90” promotes the goal of 90% viral suppression among people on treatment, which modeling suggested was critical to reaching the global vision of controlling the HIV epidemic by 2030 [3].

Source:

http://doi.org/10.1371/journal.pmed.1002820

 

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