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UVRI Checks Efficacy of Point of Care Test in Detecting Viral Load in HIV Positive Children

Viral load testing according to experts is crucial in the treatment of HIV as it helps in making treatment decisions which in the end help the patient to suppress the virus and improve their quality of life.
Principal investigator Dr. Joseph Lutakome (L) chats with colleague at the launch of the study

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The Uganda Virus Research Institute (UVRI) has embarked on a new study to establish how effective it is to use a point of care test in detecting virus levels in children and adolescents. At the moment, viral load testing is conducted only at the Uganda National Public Health Laboratory in Butabika.

Viral load testing according to experts is crucial in the treatment of HIV as it helps in making treatment decisions which in the end help the patient to suppress the virus and improve their quality of life.

Dr Benard Kikaire, a UVRI based researcher says that with the existing centralized monitoring of a viral load where the samples have to be moved to Kampala, treatment decisions are delayed and many times suffer challenges such as delayed delivery of results and mislabeling of samples among others.

For him, the new innovation involving one receiving their results about 70 minutes after the samples are drawn at the facility will likely be a game-changer in care since Uganda is currently struggling to reach the 95-95-95 UNAIDS strategy of having everyone on treatment achieving 95 per cent suppression of the virus. The study will also be conducted in Kenya, Tanzania and Rwanda, covering a total of 2,100 children. 

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Currently, in Uganda, up to 25 per cent of children on treatment are not suppressing the virus, something that is attributed to non-adherence to anti-retroviral drugs. According to the Ministry of Health guidelines, adults on HIV treatment are supposed to be tested every year to monitor whether they are suppressing. On the other hand, children are supposed to be tested every after six months but only a few turn up for this regular monitoring.  

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According to UVRI, the new study will be done for a duration of four years whereby in Uganda, six health facilities sampled from across the country will be involved and three will be equipped with the M-Pima testing machines for point care monitoring and three other sites will be analyzed on effectiveness in using the already existing centralized monitoring.

Dr Joseph Lutakome, the Principal investigator on the study says each child enrolled on the study will participate for a year. Apart from testing effectiveness in detecting viral load, they are also analyzing to see if M-Pima is a new technology in diagnosis that can be used well in both urban and rural settings in addition to whether it’s generally acceptable by the health workers.

According to specifications on the test kit, they don’t require cold chain storage to operate and it detects both HIV type 1 and type II strains that exist in the country.

Dr Charles Olaro, the Director Curative Health Services in the Ministry of Health said the study is timely considering that the country is now aiming to reach the 95 95 95 goals which stand for 95 per cent of the people in the country knowing their status, 95 per cent of the positive being on treatment and 95 per cent of those on treatment being able to suppress their virus.

Currently, he says among adolescents of 10 to 19 years, suppression levels stand at 61 per cent whereas for children it’s low at about 50 per cent.  For him, once this study, if successful, will help inform policy change for treatment in especially children.  He added that research showing undetectable viral loads means one will not only be at a lower risk of developing AIDS but also their risk of developing resistance to ARVs will be lower.