Scaling Up HIV Viral Load—Lessons from the Large-Scale Implementation of HIV Early Infant Diagnosis and CD4 Testing

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Peter T. et al. JIAS (2017), 20(S7): e25008. doi:10.1002/jia2.25008.

To inform the scale-up of viral load testing, this commentary reviews the challenges and solutions from the large-scale implementation of other diagnostic tests including nucleic-acid based early infant HIV diagnosis (EID) and CD4 testing, and identifies key lessons. The lessons and innovations from large-scale EID and CD4 programs demonstrate the importance of an integrated approach to health system strengthening focusing on data systems, supply efficiencies, and network management as well as need for more innovative approaches and effective partnerships to achieve equitable and cost-effective test access.