Journal of
AIDS and HIV Research

  • Abbreviation: J. AIDS HIV Res.
  • Language: English
  • ISSN: 2141-2359
  • DOI: 10.5897/JAHR
  • Start Year: 2009
  • Published Articles: 258

Full Length Research Paper

A study of outcomes of seven years' viral load testing at the National Public Health Laboratory, Nepal

Geeta Shakya
  • Geeta Shakya
  • National Public Health Laboratory, Kathmandu, Nepal
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Raj Kumar Mahto
  • Raj Kumar Mahto
  • National Public Health Laboratory, Kathmandu, Nepal
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Sundar Khadka
  • Sundar Khadka
  • National Public Health Laboratory, Kathmandu, Nepal
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Subhash Dhital
  • Subhash Dhital
  • National Public Health Laboratory, Kathmandu, Nepal
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Jagat Bahadur Baniya
  • Jagat Bahadur Baniya
  • National Public Health Laboratory, Kathmandu, Nepal
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Lilee Shrestha
  • Lilee Shrestha
  • National Public Health Laboratory, Kathmandu, Nepal
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Shravan Kumar Mishra
  • Shravan Kumar Mishra
  • National Public Health Laboratory, Kathmandu, Nepal
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Khagendra, K. C
  • Khagendra, K. C
  • National Public Health Laboratory, Kathmandu, Nepal
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Chet Ojha
  • Chet Ojha
  • National Public Health Laboratory, Kathmandu, Nepal
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Bishnu Prasad Upadhyay
  • Bishnu Prasad Upadhyay
  • National Public Health Laboratory, Kathmandu, Nepal
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  •  Received: 18 June 2017
  •  Accepted: 29 August 2017
  •  Published: 31 December 2017

Abstract

The benefits of antiretroviral therapy (ART) in patients living with HIV (PLWH) in Nepal have been obvious. However, their viral load (VL) and the effects of VL testing scale-up on the outcomes of HIV treatment have not been adequately investigated. In Nepal, VL tests were performed since 2009 at National Public Health laboratory. VL testing for monitoring scale up was introduced in 2014. The present study was undertaken to find out the virological failure (VF) and virological suppression (VS) rates in PLWH on ART in Nepal and to assess the effect of VL testing coverage on ART outcomes. A total of 8,230 blood/plasma samples were collected from among 11,922 patients on ART during 2009 to 2015. The VL testing coverage in 2009 was 2.9% which increased to 48.3% in 2015. VF was 35.9% in 2009 (mean for 2009-2013 was 27.5% and for 2014-2015 the mean VF was 10.2%).  Decrease in VF to nearly one third in 2015 coincided with the rise in VL testing coverage (from 2.9 to 48.3%). Improvement in VL testing coverage for ART monitoring coincided with decline in VF, indicative of ART optimization. VL testing of ART treatment failure cases only in the first segment of the study (2009-2013), accounted for initial low VL coverage. However, 48.3% coverage in the last year of scale-up period, with a mean VF of 10.2% and nearly 90% of all those receiving ART having VS, was very encouraging.        

Key words:  Viral load testing, Nepal, outcomes.