Biomedical Research and Training Institute in collaboration with Newlands Clinic introduces viral load monitoring and HIV drug resistance genotyping services in Harare/ Zimbabwe
The goal of ART is to suppress HIV to undetectable levels (VL<50 copies/ml). Due to the current public health systems in place 76.9% of adults and 40.5% of children (National AIDS council Zimbabwe, 2014) in need of ART are receiving treatment. WHO treatment guidelines recommend that patients receive viral load (VL) tests annually to ensure they remain on an effective ART and are not on failing regimens that allow the development of resistant viral strains. HIV Drug Resistance (DR) testing is recommended, in the Guidelines for Antiretroviral Therapy for the Prevention and Treatment of HIV in Zimbabwe, for patients failing second line ART prior to switching to the more expensive 3rd line. With the prevalence of DR strains increasing in Zimbabwe (The Lancet, TenoRes study), these tests have become more important.
To address the limited access to VL and HIV DR testing we have made them easily and locally available, at low cost and a quick turnaround time. We generate a list of DR mutations across the protease and reverse transcriptase genes. This highlights the reverse transcriptase and protease inhibitors that are likely to work for the patient. A genotype can help differentiate between treatment failure (due to resistance) and non-adherence. Thus, guiding clinical decisions to manage ART.
Doctors and clinicians may refer patients to Newlands Clinic, where whole blood will be drawn for testing. The samples are processed and results are reported within 2.5 weeks.