HIV Viral Load Testing in the South African Public Health Setting in the Context of Evolving ART Guidelines and Advances in Technology, 2013 - 2022

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dc.contributor.authorHans, Lucia
dc.contributor.authorCassim, Naseem
dc.contributor.authorSarang, Somayya
dc.contributor.authorHardie, Diana
dc.contributor.authorNdlovu, Silence
dc.contributor.authorVenter, W.D. Francois
dc.contributor.authorDa Silva, Pedro
dc.contributor.authorStevens, Wendy
dc.date.accessioned2023-09-14T13:30:41Z
dc.date.available2023-09-14T13:30:41Z
dc.date.issued2023-08-22
dc.date.updated2023-09-08T12:44:40Z
dc.description.abstractHIV viral load (VL) testing plays a key role in the clinical management of HIV as a marker of adherence and antiretroviral efficacy. To date, national and international antiretroviral treatment recommendations have evolved to endorse routine VL testing. South Africa (SA) has recommended routine VL testing since 2004. Progressively, the centralised HIV VL program managed by its National Health Laboratory Service (NHLS) has undergone expansive growth. Retrospective de-identified VL data from 2013 to 2022 were evaluated to review program performance. Test volumes increased from 1,961,720 performed in 2013 to 45,334,864 in 2022. The median total in-laboratory turnaround time (TAT) ranged from 94 h (2015) to 51 h (2022). Implementation of two new assays improved median TATs in all laboratories. Samples of VL greater than 1000 copies/mL declined steadily. Despite initial increases, samples of fewer than 50 copies/mL stagnated at about 70% from 2019 and declined to 68% in 2022. Some variations between assays were observed. Overall, the SA VL program is successful. The scale of the VL program, the largest of its kind in the world by some margin, provides lessons for future public health programs dependent on laboratories for patient outcome and program performance monitoring.
dc.identifierdoi: 10.3390/diagnostics13172731
dc.identifier.apacitationHans, L., Cassim, N., Sarang, S., Hardie, D., Ndlovu, S., Venter, W. D. Francois., ... Stevens, W. (2023). HIV Viral Load Testing in the South African Public Health Setting in the Context of Evolving ART Guidelines and Advances in Technology, 2013 - 2022. <i>Diagnostics</i>, 13(17), 2731. http://hdl.handle.net/11427/38650en_ZA
dc.identifier.chicagocitationHans, Lucia, Naseem Cassim, Somayya Sarang, Diana Hardie, Silence Ndlovu, W.D. Francois Venter, Pedro Da Silva, and Wendy Stevens "HIV Viral Load Testing in the South African Public Health Setting in the Context of Evolving ART Guidelines and Advances in Technology, 2013 - 2022." <i>Diagnostics</i> 13, 17. (2023): 2731. http://hdl.handle.net/11427/38650en_ZA
dc.identifier.citationHans, L., Cassim, N., Sarang, S., Hardie, D., Ndlovu, S., Venter, W.D. Francois., Da Silva, P. & Stevens, W. et al. 2023. HIV Viral Load Testing in the South African Public Health Setting in the Context of Evolving ART Guidelines and Advances in Technology, 2013 - 2022. <i>Diagnostics.</i> 13(17):2731. http://hdl.handle.net/11427/38650en_ZA
dc.identifier.ris TY - Journal Article AU - Hans, Lucia AU - Cassim, Naseem AU - Sarang, Somayya AU - Hardie, Diana AU - Ndlovu, Silence AU - Venter, W.D. Francois AU - Da Silva, Pedro AU - Stevens, Wendy AB - HIV viral load (VL) testing plays a key role in the clinical management of HIV as a marker of adherence and antiretroviral efficacy. To date, national and international antiretroviral treatment recommendations have evolved to endorse routine VL testing. South Africa (SA) has recommended routine VL testing since 2004. Progressively, the centralised HIV VL program managed by its National Health Laboratory Service (NHLS) has undergone expansive growth. Retrospective de-identified VL data from 2013 to 2022 were evaluated to review program performance. Test volumes increased from 1,961,720 performed in 2013 to 45,334,864 in 2022. The median total in-laboratory turnaround time (TAT) ranged from 94 h (2015) to 51 h (2022). Implementation of two new assays improved median TATs in all laboratories. Samples of VL greater than 1000 copies/mL declined steadily. Despite initial increases, samples of fewer than 50 copies/mL stagnated at about 70% from 2019 and declined to 68% in 2022. Some variations between assays were observed. Overall, the SA VL program is successful. The scale of the VL program, the largest of its kind in the world by some margin, provides lessons for future public health programs dependent on laboratories for patient outcome and program performance monitoring. DA - 2023-08-22 DB - OpenUCT DP - University of Cape Town IS - 17 J1 - Diagnostics LK - https://open.uct.ac.za PY - 2023 T1 - HIV Viral Load Testing in the South African Public Health Setting in the Context of Evolving ART Guidelines and Advances in Technology, 2013 - 2022 TI - HIV Viral Load Testing in the South African Public Health Setting in the Context of Evolving ART Guidelines and Advances in Technology, 2013 - 2022 UR - http://hdl.handle.net/11427/38650 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/38650
dc.identifier.vancouvercitationHans L, Cassim N, Sarang S, Hardie D, Ndlovu S, Venter WD Francois, et al. HIV Viral Load Testing in the South African Public Health Setting in the Context of Evolving ART Guidelines and Advances in Technology, 2013 - 2022. Diagnostics. 2023;13(17):2731. http://hdl.handle.net/11427/38650.en_ZA
dc.publisherMultidisciplinary Digital Publishing Institute
dc.publisher.departmentDivision of Medical Virology
dc.publisher.facultyHealth Science
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceDiagnostics
dc.source.journalissue17
dc.source.journalvolume13
dc.source.pagination2731
dc.source.urihttps://www.mdpi.com/journal/diagnostics
dc.titleHIV Viral Load Testing in the South African Public Health Setting in the Context of Evolving ART Guidelines and Advances in Technology, 2013 - 2022
dc.typeJournal Article
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