Pooled testing: A tool to increase efficiency of infant HIV diagnosis and virological monitoring

African Journal of Laboratory Medicine

 
 
Field Value
 
Title Pooled testing: A tool to increase efficiency of infant HIV diagnosis and virological monitoring
 
Creator Preiser, Wolfgang van Zyl, Gert U.
 
Subject HIV; antiretroviral treatment; early infant diagnosis; pooling; pooled testing; HIV; antiretroviral treatment; early infant diagnosis; pooling; pooled testing
Description Background: Pooled testing, or pooling, has been used for decades to efficiently diagnose relatively rare conditions, such as infection in blood donors. Programmes for the prevention of mother-to-child transmission of HIV and for antiretroviral therapy (ART) are being rolled out in much of Africa and are largely successful. This increases the need for early infant diagnosis (EID) of HIV using qualitative nucleic acid testing and for virological monitoring of patients on ART using viral load testing. While numbers of patients needing testing are increasing, infant HIV infections and ART failures are becoming rarer, opening an opportunity for pooled testing approaches.Aim: This review highlights the need for universal EID and viral load coverage as well as the challenges faced. We introduce the concept of pooled testing and highlight some important considerations before giving an overview of studies exploring pooled testing for EID and virological monitoring.Results: For ART monitoring, pooling has been shown to be accurate and efficient; for EID it has not been tried although modelling shows it to be promising. The final part attempts to place pooling into the context of current mother-to-child transmission of HIV and ART programmes and their expected trajectories over the next years.Conclusion: Several points warrant consideration: pre-selection to exclude samples with an elevated pre-test probability of positivity from pooled testing, the use of dried blood or plasma spots, and choosing a pooling strategy that is both practically feasible and economical. Finally, novel ideas are suggested to make pooling even more attractive.
 
Publisher AOSIS
 
Contributor South African Medical Research Council
Date 2020-08-11
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Review
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/ajlm.v9i2.1035
 
Source African Journal of Laboratory Medicine; Vol 9, No 2 (2020); 7 pages 2225-2010 2225-2002
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://ajlmonline.org/index.php/ajlm/article/view/1035/1553 https://ajlmonline.org/index.php/ajlm/article/view/1035/1552 https://ajlmonline.org/index.php/ajlm/article/view/1035/1554 https://ajlmonline.org/index.php/ajlm/article/view/1035/1551
 
Coverage sub-Saharan Africa; resource-limited settings current HIV-infected and -exposed individuals
Rights Copyright (c) 2020 Wolfgang Preiser, Gert U. van Zyl https://creativecommons.org/licenses/by/4.0
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