HIV viral load messages should go viral in India

Isaakidis, Petros; Gupta, Shailly; Das, Mrinalini; Ferrer, Daniel; Nalinikanta, Rajkumar; Reid, Tony; Horn, Tim; Frick, Mike

doi:10.1016/s2352-3018(15)00180-0

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…In India, serious concerns have been expressed over the scarcity of adequate access to HIV viral load testing; according to one estimate, more than 800 000 tests are needed annually, whereas only about 7000 are being done. 7 In this context, the Xpert HIV-1 Viral Load (Cepheid) cartridge was launched in 2014, as a potential point-of-care, rapid viral load assay. However, before the Xpert HIV-1 Viral Load cartridge can be clinically used in India, validation is essential.…”

Section: Use Of the Genexpert Tuberculosis System For Hiv Viral Load mentioning

confidence: 99%

Use of the GeneXpert tuberculosis system for HIV viral load testing in India

Nash

Ramapuram

Kaiya

et al. 2017

The Lancet Global Health

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Section: Use Of the Genexpert Tuberculosis System For Hiv Viral Load mentioning

confidence: 99%

Use of the GeneXpert tuberculosis system for HIV viral load testing in India

Nash

Ramapuram

Kaiya

et al. 2017

The Lancet Global Health

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“…An important element in meeting this target is the World Health Organization (WHO) recommendation of integrating routine HIV viral load (VL) testing in HIV programs, to monitor the response to ART and detect treatment failure in a timely manner [4]. However, access to routine VL testing along with enhanced adherence counseling is not keeping pace with ART scale-up, mainly due to prohibitive costs and lack of availability [5–7]. Drug sensitivity testing too is not yet a standard component of care, especially in resource-limited settings, despite the considerable threat that resistance poses to the HIV control efforts that have been realized over the past years [8,9].…”

Section: Introductionmentioning

confidence: 99%

Genotyping and outcomes of presumptive second line ART failure cases switched to third line or maintained on second line ART in Mumbai, India

Gill¹,

Bergh²,

Kyaw³

et al. 2019

PLoS ONE

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BackgroundHIV programs are increasingly confronted with failing antiretroviral therapy (ART), including second-line regimens. WHO has provided guidelines on switching to third-line ART. In a Médecins Sans Frontières clinic in Mumbai, India, receiving referred presumptive second-line ART failure cases, an evidence-based protocol consisting of viral load (VL) testing, enhanced adherence counselling (EAC) and genotype for switching was implemented.ObjectiveTo document the outcome and genotype of presumptive second-line ART failure cases switched to third-line or maintained on second-line ART.DesignRetrospective cohort study of patients referred between January 2011 and September 2017.ResultsThe cases (n = 120) were complex with median 9.2 years of ART exposure, poor adherence at baseline, and exposure to multiple ART regimens other than recommended by WHO. Out of 90 evaluated cases, 39(43%) were maintained on second-line ART. Forty-nine (54%) were ever switched to third-line ART. Twelve months virological suppression was 72% in the second-line and 93% in the third-line ART cohort, while retention in care was 80% and 94% respectively. Genotyping showed 62% resistance for PIs, and 52% triple class resistance to NRTIs, NNRTIs and PIs. Resistance was noted for the new class of integrase inhibitors, and for different drugs without any documented previous exposure to the same drug.ConclusionAdopting WHO guidelines on switching ART regimens and provision of EAC can prevent unnecessary switching/exposure to third-line ART regimens. Genotyping is urgently required in national HIV programs, which currently use only the exposure history of patients for switching to third-line ART regimens.

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HIV viral load messages should go viral in India

Cited by 2 publications

References 7 publications

Use of the GeneXpert tuberculosis system for HIV viral load testing in India

Use of the GeneXpert tuberculosis system for HIV viral load testing in India

Genotyping and outcomes of presumptive second line ART failure cases switched to third line or maintained on second line ART in Mumbai, India

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