南苏丹扩大病毒载量检测规模：利用工具策略性实施，监测艾滋病毒感染者的艾滋病毒治疗效果。

Viral load scale-up in south Sudan: Strategic implementation of tools to monitor HIV treatment success among people living with HIV.

机构信息

Division of Global HIV & TB, Center for Global Health, 1242Centers for Disease Control and Prevention, Atlanta, GA, USA.

Ministry of Health, National Public Health Laboratory, Juba, South Sudan.

出版信息

Int J STD AIDS. 2022 Jul;33(8):784-791. doi: 10.1177/09564624221103045. Epub 2022 May 26.

DOI:10.1177/09564624221103045

PMID:35618534

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9668367/

Abstract

INTRODUCTION

As access to antiretroviral therapy (ART) for people with HIV (PWH) in the Republic of South Sudan (RSS) increases, viral load (VL) suppression is critical to protect global HIV response investments. We describe VL scale-up between 2017-2020 in the RSS President's Emergency Plan for AIDS Relief (PEPFAR)-supported program.

METHODS

President's Emergency Plan for AIDS Relief (PEPFAR) South Sudan developed a VL scale-up plan and tools spanning the VL cascade: pre-test, test and post-test and included assessment of clinical facility and laboratory readiness; clinical and laboratory forms and standard operating procedures for test ordering, specimen collection, processing, results return and utilization; procedures to map clients, monitor turn-around-times (TAT), and an electronic system to monitor VL performance.

RESULTS

Between 2017 to 2020, VL monitoring was established in 58 facilities, with 59,600 VL samples processed, and improvements in TAT (150-28 days) and rejection rates (1.9%-0.8%). VL documentation improved for dates of ART initiation, VL test request and dispatch, and HIV regimen. Total average time from high VL to repeat VL decreased from 15.9 months to 6.4 months in 2017 and 2019, respectively.

CONCLUSIONS

A concerted approach to VL scale-up has been fundamental as South Sudan strives towards UNAIDS 95-95-95 targets for PWH on ART.

摘要

简介

随着南苏丹共和国（RSS）获得抗逆转录病毒疗法（ART）的机会增加，病毒载量（VL）抑制对于保护全球 HIV 应对投资至关重要。我们描述了 RSS 总统艾滋病紧急救援计划（PEPFAR）支持的项目中 2017 年至 2020 年期间 VL 的扩大情况。

方法

总统艾滋病紧急救援计划（PEPFAR）南苏丹制定了一个 VL 扩大计划和工具，涵盖了 VL 级联：检测前、检测中和检测后，并包括评估临床设施和实验室准备情况；测试订单、标本采集、处理、结果返回和利用的临床和实验室表格和标准操作程序；用于绘制客户、监测周转时间（TAT）以及监测 VL 性能的电子系统的程序。

结果

在 2017 年至 2020 年期间，VL 监测在 58 个设施中建立起来，处理了 59600 个 VL 样本，并且 TAT（150-28 天）和拒收率（1.9%-0.8%）得到了改善。VL 文档记录得到了改进，包括开始 ART 的日期、VL 测试请求和派遣，以及 HIV 方案。从高 VL 到重复 VL 的总平均时间从 2017 年和 2019 年的 15.9 个月分别减少到 6.4 个月。