New in Viral Load Testing

Viral load monitoring is the key to measuring HIV treatment success and achievement of the third 90. The goal of antiretroviral therapy (ART) is viral suppression—viral load that is so low that it cannot be detected by viral load tests. Achieving the third of UNAIDS' 90-90-90 targets means that, by 2020, 73% of all people living with HIV will have suppressed viral loads. This collection of resources and tools helps you find what you need to scale up viral load testing.

Global Guidance and Country Experiences

New! Key Considerations for Introducing New HIV Point-of-Care Diagnostic Technologies in National Health Systems

UNICEF, ASLM, CDC, CHAI, OGAC, EGPAF, LSHTM, ICAP, MSF, NHLS, USAID, and WHO, 2018.

This report describes the key areas that national governments should consider for the introduction and scale-up of point-of-care (POC) diagnostics within national programs as new innovative POC technologies are introduced. It includes considerations and steps for introducing HIV POC technologies including: policy and framework development; strategy and planning; regulations; quality assurance and data management; procurement and supply chain management; implementation; and monitoring and evaluation (M&E). Also available in French.

Laboratory Management

New! Key Considerations for Introducing New HIV Point-of-Care Diagnostic Technologies in National Health Systems

UNICEF, ASLM, CDC, CHAI, OGAC, EGPAF, LSHTM, ICAP, MSF, NHLS, USAID, and WHO, 2018.

This report describes the key areas that national governments should consider for the introduction and scale-up of point-of-care (POC) diagnostics within national programs as new innovative POC technologies are introduced. It includes considerations and steps for introducing HIV POC technologies including: policy and framework development; strategy and planning; regulations; quality assurance and data management; procurement and supply chain management; implementation; and monitoring and evaluation (M&E). Also available in French.

New! HIV Point-of-Care Diagnostics Toolkit

UNICEF, CHAI, ASLM, EGPAF, CDC, WHO, Unitaid, 2018.

An extension of Key Considerations for Introducing New HIV Point-of-Care (POC) Diagnostic Technologies in National Health Systems, this Toolkit contains practical tools and guidance to support countries as they introduce POC HIV technologies into existing national diagnostic networks and laboratory systems. It provides a roadmap as countries seek to expand access to quality-assured HIV diagnostics. The toolkit is organized in four modules: (1) Product and Site Selection; (2) Forecasting and Supply Planning; (3) Regulations; and (4) Quality Assurance. Though most links are to documents in English, portions of the site are available in Amharic, French, Portuguese, and Swahili.

New! [Collection ] India Viral Load Testing Guidance

India National AIDS Control Organsation (NACO), 2018.

In 2018, India implemented routine viral load (VL) testing for all people living with HIV releasing a set of guidance documents to support the scale-up of VL testing to reach the 90-90-90 targets in India—this collection includes National Guidelines for HIV-1 Viral Load Laboratory Testing, National Operational Guidelines for Viral Load Testing, and Guidelines on Quality Monitoring System for Outsourced Viral Load Tests.

  • National Guidelines for HIV-1 Viral Load Laboratory Testing

    India National AIDS Control Organsation (NACO), 2018.

    The National Guidelines for HIV-1 Viral Load Laboratory Testing support plans to scale up viral load (VL) testing to reach the 90-90-90 targets in India. This phased scale-up includes the setup of 70 additional VL testing laboratories nationally. These guidelines include laboratory design considerations, a summary of VL technologies, and specimen collection and handling as well as transportation and storage guidance. Quality control and quality assurance requirements are described as well as laboratory safety issues. The guidelines also describe the VL laboratory network to be developed with supply chain management issues and commodities described. Annexes include laboratory registers and reporting forms.

  • National Operational Guidelines for Viral Load Testing

    India National AIDS Control Organsation (NACO), 2018.

    These National Operational Guidelines for Viral Load Testing detail how routine viral load testing will be implemented at the facility level in India. They include frequency and interpretation of monitoring, sample collections, storage and transportation, receipt of results, adherence counseling, and reporting requirements. Roles and responsibilities are outlined as well as turnaround time requirements.

  • Guidelines on Quality Monitoring System for Outsourced Viral Load Tests

    India National AIDS Control Organsation (NACO), 2018.

    This document provides guidelines and tools for monitoring the quality of outsourced viral load test results in India, defining processes and procedures as well as quality indicators and a monitoring checklist for assuring quality of services. Annexes include reporting forms and checklists for monitoring visits.

New! HIV Point-of-Care (Nucleic Acid Tests) Landscape in Africa

African Society for Laboratory Medicine (ASLM), 2017.

Strategic deployment of point-of-care (POC) infant diagnosis is key in getting more infants tested for HIV and initiated on treatment in a timely manner. This ASLM map—updated in November 2017—indicates the POC technologies being utilized by countries in Africa.

Logistics

New! Key Considerations for Introducing New HIV Point-of-Care Diagnostic Technologies in National Health Systems

UNICEF, ASLM, CDC, CHAI, OGAC, EGPAF, LSHTM, ICAP, MSF, NHLS, USAID, and WHO, 2018.

This report describes the key areas that national governments should consider for the introduction and scale-up of point-of-care (POC) diagnostics within national programs as new innovative POC technologies are introduced. It includes considerations and steps for introducing HIV POC technologies including: policy and framework development; strategy and planning; regulations; quality assurance and data management; procurement and supply chain management; implementation; and monitoring and evaluation (M&E). Also available in French.

New! HIV Point-of-Care Diagnostics Toolkit

UNICEF, CHAI, ASLM, EGPAF, CDC, WHO, Unitaid, 2018.

An extension of Key Considerations for Introducing New HIV Point-of-Care (POC) Diagnostic Technologies in National Health Systems, this Toolkit contains practical tools and guidance to support countries as they introduce POC HIV technologies into existing national diagnostic networks and laboratory systems. It provides a roadmap as countries seek to expand access to quality-assured HIV diagnostics. The toolkit is organized in four modules: (1) Product and Site Selection; (2) Forecasting and Supply Planning; (3) Regulations; and (4) Quality Assurance. Though most links are to documents in English, portions of the site are available in Amharic, French, Portuguese, and Swahili.

New! [Collection ] India Viral Load Testing Guidance

India National AIDS Control Organsation (NACO), 2018.

In 2018, India implemented routine viral load (VL) testing for all people living with HIV releasing a set of guidance documents to support the scale-up of VL testing to reach the 90-90-90 targets in India—this collection includes National Guidelines for HIV-1 Viral Load Laboratory Testing, National Operational Guidelines for Viral Load Testing, and Guidelines on Quality Monitoring System for Outsourced Viral Load Tests.

  • National Guidelines for HIV-1 Viral Load Laboratory Testing

    India National AIDS Control Organsation (NACO), 2018.

    The National Guidelines for HIV-1 Viral Load Laboratory Testing support plans to scale up viral load (VL) testing to reach the 90-90-90 targets in India. This phased scale-up includes the setup of 70 additional VL testing laboratories nationally. These guidelines include laboratory design considerations, a summary of VL technologies, and specimen collection and handling as well as transportation and storage guidance. Quality control and quality assurance requirements are described as well as laboratory safety issues. The guidelines also describe the VL laboratory network to be developed with supply chain management issues and commodities described. Annexes include laboratory registers and reporting forms.

  • National Operational Guidelines for Viral Load Testing

    India National AIDS Control Organsation (NACO), 2018.

    These National Operational Guidelines for Viral Load Testing detail how routine viral load testing will be implemented at the facility level in India. They include frequency and interpretation of monitoring, sample collections, storage and transportation, receipt of results, adherence counseling, and reporting requirements. Roles and responsibilities are outlined as well as turnaround time requirements.

  • Guidelines on Quality Monitoring System for Outsourced Viral Load Tests

    India National AIDS Control Organsation (NACO), 2018.

    This document provides guidelines and tools for monitoring the quality of outsourced viral load test results in India, defining processes and procedures as well as quality indicators and a monitoring checklist for assuring quality of services. Annexes include reporting forms and checklists for monitoring visits.

Clinical Implementation

New! Pregnant and Breastfeeding Women: A Priority Population for HIV Viral Load Monitoring

PLOS One, 2017.

Although the importance of routine viral load (VL) monitoring for HIV-infected individuals on ART is widely recognized, there has been minimal attention to VL monitoring in pregnancy and the postpartum period. This article highlights key considerations for VL monitoring in pregnant and breastfeeding women in the context of expanding access to VL monitoring.