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báo cáo hóa học:" Viral load testing in a resource-limited setting: quality control is critical"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học đề tài : Viral load testing in a resource-limited setting: quality control is critical | JOURNALOF THE INTERNATIONAL AIDS SOCIETY Greig et al. Journal of the International AIDS Society 2011 14 23 http www.jiasociety.Org content 14 1 23 SHORT REPORT Open Access Viral load testing in a resource-limited setting quality control is critical hna Groin 1DbiIinn Hl I r rnc1 rhorrx nl IKGrlznxA cIzi2 GGir K iillc2 QtcFFon l TimQncQn3 D DinH rH I l rrinTm4 TinH Jane Gieig Philipp du Cios Deiiyck Klaikowski Claii Mills Steffen J0igensen P Ricnaid Haiiigan and Daniel P O Biien2 Abstract Background Woild Health Oiganization guidelines now recommend routine use of vital load testing where available foi patients receiving antiretroviral treatment ART . Howevei its use has not been routinely implemented in many resource-limited settings due to cost availability and accessibility. Vital load testing is complex making its application in resource-limited settings challenging. We describe the issues encountered by Médecins Sans Fiontieies MSF when using routine viral load testing in a laige HIV programme in sub-Saharan Africa. Methods Between Octobei 2005 and August 2006 moie than 1200 patients on ART had viral load tests at baseline and at thiee-month inteivals peifoimed by a local reference laboiatoiy that was quality assured by an experienced international institution. Concerns with reliability of results halted testing. The quality control measures instituted with a second laboiatoiy and outcomes of these weie documented. Results In 2005 and 2006 only 178 of 334 53 previously ART-naive patients tested aftei six to 12 months of treatment had viral loads of less than 1000 copies mL. Similai MSF programmes elsewhere demonstrated viiological suppiession iates of moie than 85 and duplicate testing showed unacceptable discoidance. Laboiatoiy problems encountered included disiegaided quality control time delays requirement foi ietesting and duplicate sample variations. Potentially haimful clinical outcomes of inaccurate viral load results include unnecessaiy ART iegimen .