Benefit of viral load testing for confirmation of immunological failure in HIV patients treated in rural Malawi

摘要: OBJECTIVE: Viral load testing is used in the HIV programme of Chiradzulu, Malawi, to confirm diagnosis immunological failure prevent unnecessary switching second-line therapy. Our objective was quantify benefit this strategy for management treatment a large decentralized Africa. METHODS: Retrospective analysis monitoring data from adults treated with first-line antiretroviral regimens >1 year and meeting WHO criteria an rural Malawi. The positive predictive value using diagnose virological (viral >5000 copies/ml) estimated. RESULTS: Of 227 patients (185 confirmed repeat CD4 measurement), 155 (68.2%) had confirmatory viral testing. Forty-four (28.4%) copies/ml 57 (36.8%) >1000 copies/ml. Positive 28.4% (95% CI 21.4-36.2%). Repeat count showed that 41% initially diagnosed did no longer meet criteria. CONCLUSIONS: results support need confirming all cases before ART optimize use resources developing countries.