CROI 2019: Point-of-care viral load testing improves HIV outcomes, researchers say

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Science Speaks is in Seattle this week covering breaking news in HIV research, policies and plans at CROI 2019 March 4-7.

SEATTLE – People living with HIV who undergo HIV viral load testing at the point of health care delivery and receive their results immediately go on to achieve undetectable viral loads at higher rates than people whose  testing is done at laboratories, researchers said here.

Results from the Simplifying HIV Treatment and Monitoring – or STREAM study – conducted in Durban, South Africa found that nearly 90 percent of study participants who received point-of-care viral load testing and same-day counseling had achieved viral suppression 12 months after testing, compared to 76 percent of participants who waited for the results of viral load testing conducted at laboratories — part of the prevailing standard of care  — Dr. Paul Drain of the University of Washington said here.

Subjects whose samples were sent to labs were notified of their viral load results on average 28 days later, Drain said, compared to subjects who received their results within hours and had their results uploaded to the health information system within two days.

Delays in obtaining results prolongs the time it takes for people living with HIV to receive the appropriate treatment they need to decrease viral load, Dr. Drain said, which contributes to inadequate levels of viral suppression globally. Immediate sharing of viral load also results improves retention in care, he said, which improves treatment outcomes and contributes to a better viral suppression.

“What is good about POC testing is that you leave knowing that you need to fix that issue, if there is anything to fix,” said one of the study participants, quoted by Dr. Drain in his presentation.

The 14 percent increase in viral load suppression among subjects who received same-day results is significant, Dr. Drain said, as people on HIV treatment who achieve viral suppression do not transmit the virus. More efficient and timelier viral load testing could help towards achieving UNAIDS’ global target of 90 percent of people on HIV treatment being virally suppressed.

Point of care viral load testing is not only more efficient and effective, it also costs less, Dr. Drain said: The point of care test used in the study cost $21.53 per test compared to $25.98 per test done at a centralized lab.

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