Implementing and using viral load testing : practical tools

Strengthening the capacities of Guinean prescribers is an important part of the OPP-ERA project. Indeed, if the request for viral load testing is constantly increasing since the start of the project, the use of the results of the examinations must be reinforced:

There is a need for prescribers to better apply national and international recommendations on the use of CV, ie if an HIV patient has a first detectable CV, he / she should immediately benefit from increased adherence and then 3 to 6 months after this reinforcement of the observance, a new examination of CV must be systematically proposed to him. If the CV is still detectable, then the patient must be able to change the line of treatment.

The main challenge is to ensure that viral load tests’ results are used for appropriate monitoring of the patient care. To this end, the OPP-ERA team has developed specific tools (accessible database, electronic file for monitoring viral load tests results, etc.), and provides regular training (virological failure management) and tutoring on the site.

In this context, an important activity is the organization of the Technical Medical Committees. These committees bring together all the actors involved in HIV care in Conakry, including viral load testing laboratory managers, as well as those responsible for the National Program against HIV / AIDS and Hepatitis.

Technical Medical Committees are very important as they provide a forum for dialogue between prescribers and the laboratory. The results of viral load testing activities are thus shared and analyzed with all the actors and adapted solutions are planned and implemented. The interface between care units and laboratories is thereby reinforced, for the benefit of HIV-infected patients on ARVs treatment.

On October 11, 2018, the 4th Medical Technical Committee of the OPP-ERA project was organized in the same line at the Donka National Hospital. The committee gathered together the Chairman of the Medical Therapeutics Committee of the Guinean Health Ministry, by the managers of 11 HIV care sites in Conakry and by the heads of molecular biology laboratories. The objectives for the year 2019 had thus been defined and will be regularly evaluated.

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Guinea: Improving the use of HIV viral load tests by clinicians for appropriate care of HIV infected-patients

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