Low-level viraemia: An emerging concern among people living with HIV in Uganda and across sub-Saharan Africa

African Journal of Laboratory Medicine

 
 
Field Value
 
Title Low-level viraemia: An emerging concern among people living with HIV in Uganda and across sub-Saharan Africa
 
Creator Nanyeenya, Nicholus Kiwanuka, Noah Nakanjako, Damalie Nakigozi, Gertrude Kibira, Simon P.S. Nabadda, Susan Kiyaga, Charles Sewanyana, Isaac Nasuuna, Esther Makumbi, Fredrick
 
Subject — HIV/AIDS; low-level viraemia; viral load testing; non-suppression; virologic failure
Description Attaining viral load (VL) suppression for over 95% of the people living with HIV on antiretroviral therapy is a fundamental step in enabling Uganda and other sub-Saharan African countries to achieve global Sustainable Development Goal targets to end the HIV/AIDS epidemic by 2030. In line with the 2013 World Health Organization recommendations, several sub-Saharan African countries, including Uganda, use a threshold of 1000 HIV viral RNA copies/mL to determine HIV viral non-suppression. The United States Centers for Disease Control and Prevention and the International Association of Providers of AIDS Care deem this threshold very high, and hence recommend using 200 copies/mL to determine viral non-suppression. Using 1000 copies/mL as a threshold ignores people living with HIV who have low-level viraemia (LLV; HIV VL of at least 50 copies/mL but less than 1000 copies/mL). Despite the 2021 World Health Organization recommendations of using intensive adherence counselling for people living with HIV with LLV, several sub-Saharan African countries have no interventions to address LLV. However, recent studies have associated LLV with increased risks of HIV drug resistance, virologic failure and transmission. The purpose of this narrative review is to provide insights on the emerging concern of LLV among people living with HIV receiving antiretroviral therapy in sub-Saharan Africa. The review also provides guidance for Uganda and other sub-Saharan African countries to implement immediate appropriate interventions like intensive adherence counselling, reducing VL thresholds for non-suppression and conducting more research to manage LLV which threatens progress towards ending HIV by 2030.
 
Publisher AOSIS
 
Contributor
Date 2022-10-20
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/ajlm.v11i1.1899
 
Source African Journal of Laboratory Medicine; Vol 11, No 1 (2022); 5 pages 2225-2010 2225-2002
 
Language eng
 
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https://ajlmonline.org/index.php/ajlm/article/view/1899/2433 https://ajlmonline.org/index.php/ajlm/article/view/1899/2434 https://ajlmonline.org/index.php/ajlm/article/view/1899/2435 https://ajlmonline.org/index.php/ajlm/article/view/1899/2436
 
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Rights Copyright (c) 2022 Nicholus Nanyeenya, Noah Kiwanuka, Damalie Nakanjako, Gertrude Nakigozi, Simon P.S. Kibira, Susan Nabadda, Charles Kiyaga, Isaac Sewanyana, Esther Nasuuna, Fredrick Makumbi https://creativecommons.org/licenses/by/4.0
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