Point-of-care viral load testing among adolescents and young adults living with HIV in Haiti: a randomized control trial.

Autor: Reif LK; Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, NY, USA.; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA., Belizaire ME; GHESKIO Center, Port-au-Prince, Haiti., Rouzier V; Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, NY, USA.; GHESKIO Center, Port-au-Prince, Haiti., Seo G; Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, NY, USA., Severe P; GHESKIO Center, Port-au-Prince, Haiti., Bajo Joseph JM; GHESKIO Center, Port-au-Prince, Haiti., Joseph B; GHESKIO Center, Port-au-Prince, Haiti., Apollon S; GHESKIO Center, Port-au-Prince, Haiti., Pape JW; Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, NY, USA.; GHESKIO Center, Port-au-Prince, Haiti., McNairy ML; Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, NY, USA.; Division of General Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, USA., Elul B; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA., Fitzgerald DW; Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, NY, USA., Arpadi SM; ICAP at Columbia University, Mailman School of Public Health, Columbia University, NY, USA.; Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA., Abrams EJ; ICAP at Columbia University, Mailman School of Public Health, Columbia University, NY, USA.; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.; Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA., Kuhn L; Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Jazyk: angličtina
Zdroj: AIDS care [AIDS Care] 2022 Apr; Vol. 34 (4), pp. 409-420. Date of Electronic Publication: 2021 Oct 06.
DOI: 10.1080/09540121.2021.1981816
Abstrakt: HIV viral load (VL) monitoring can reinforce antiretroviral therapy (ART) adherence. Standard VL testing requires high laboratory capacity and coordination between clinic and laboratory which can delay results. A randomized trial comparing point-of-care (POC) VL testing to standard VL testing among 150 adolescents and young adults, ages 10-24 years, living with HIV in Haiti determined if POC VL testing could return faster results and improve ART adherence and viral suppression. Participants received a POC VL test with same-day result (POC arm) or a standard VL test with result given 1 month later (SOC arm). POC arm participants were more likely to receive a test result within 6 weeks than SOC arm participants (94.7% vs. 80.1%; p1000 copies/ml and low self-reported ART adherence was stronger in the POC arm (OR: 6.57; 95%CI: 2.12-25.21) than the SOC arm (OR: 2.62; 95%CI: 0.97-7.44) suggesting more accurate self-report in the POC arm. POC VL testing was effectively implemented in this low-resource setting with faster results and is a pragmatic intervention that may enable clinicians to identify those with high VL to provide enhanced counseling or regimen changes sooner. Trial registration: ClinicalTrials.gov identifier: NCT03288246.
Databáze: MEDLINE
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