Cost-Effectiveness of Routine Viral Load Monitoring in Low- and Middle-Income Countries: A Systematic Review

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Barnabas R.V. et al. JIAS (2017), 20(S7): e25006. doi:10.1002/jia2.25006.

Viral load (VL) testing represents a substantial cost in resource-constrained health care systems. This systematic review identified 18 studies that evaluated the cost-effectiveness of VL monitoring in HIV treatment programs. The review identified three key factors that make it more likely for VL monitoring to be cost-effective: 1) Use of effective, lower-cost approaches to VL monitoring (e.g. use of dried blood spots); 2) Ensuring the pathway to health improvement is established and that VL results are acted upon; and 3) VL results are used to simplify HIV care in patients with viral suppression (i.e. differentiated care, with fewer clinic visits and longer prescriptions).