Toolkit
HIV Treatment and Care
The Guide to operationalize HIV viral load testing HIV presents 60 lessons learnt from the project in a systemic approach including: viral
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load strategy, laboratories, procurement and supply management, patient care and economy.
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These National Operational Guidelines for Viral Load Testing detail how routine viral load testi
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ng will be implemented at the facility level in India. They include frequency and interpretation of monitoring, sample collections, storage and transportation, receipt of results, adherence counseling, and reporting requirements. Roles and responsibilities are outlined as well as turnaround time requirements.
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The National Guidelines for HIV-1 Viral Load Laboratory Testing support plans to scale up viral load
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(VL) testing to reach the 90-90-90 targets in India. This phased scale-up includes the setup of 70 additional VL testing laboratories nationally. These guidelines include laboratory design considerations, a summary of VL technologies, and specimen collection and handling as well as transportation and storage guidance. Quality control and quality assurance requirements are described as well as laboratory safety issues. The guidelines also describe the VL laboratory network to be developed with supply chain management issues and commodities described. Annexes include laboratory registers and reporting forms.
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Version 1.1 July 2016
The purpose of this document is to describe standard operating procedures for viral load monitoring, including the schedule for
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viral load testing when used for routine monitoring of children, adolescents and adults on ART; interpretation of results; patient management; and specimen collection, preparation and transport. This template document to be adapted for use in various contexts and is one component of a viral load monitoring toolkit, to be used in conjunction with ICAP’s Viral Load Monitoring Flipchart and Enhanced Adherence Treatment Plan.
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This policy brief describes key HIV viral load thresholds and the available viral load testing a
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pproaches for monitoring how well antiretroviral therapy is working for people living with HIV. It provides clarification for and elaborates upon the current treatment monitoring algorithm from the Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach.
This information can help people living with HIV to live healthy lives, ensure that HIV is not transmitted to other people and support policy-makers in determining the optimal allocation of resources for viral load testing and communicating the results.
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The five hepatitis viruses have different epidemiological profiles, and their impact, duration, and transmission route also vary. The most common transmission routes contributing to the spread of hepatitis are exposure to infected blood via blood transfusion or unsafe injection practices, consumptio
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n of contaminated food and drinking water, and transmission from mother to child during pregnancy and delivery. Also, unsafe injection practices, including the use of unsterile needles and syringes, serve as a major pathway for the spread of hepatitis B and C, and reducing transmission of both diseases requires addressing these practices.
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Due to the anticipated significant rise in VL testing occasioned by Ghana’s adaptation of 2016 ART guidelines, it has become necessary to develop this VL scale-up and operational plan to assure complete client access to laboratory monitoring towards the achievement of the third 90 of the HIV care
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cascade. The plan will enhance VL testing, monitoring whilst improving the clinical and laboratory interface for improved client care.
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Intensificar o reforço das abordagens de monitorização do tratamento através dos testes da carga viral, assim como o diagnóstico pediátrico precoce, será fundamental para garantir cuidados e tratamentos de boa qualidade e o êxito dos program
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as. Considerar uma boa rede de diagnósticos, tipos de amostras, intervenções e estratégias em cada um dos países e em todas as partes interessadas nacionais, regionais e parceiros contribuirá para apoiar este esforço, melhorar a colaboração e maximizar o investimento nos diagnósticos para um impacto clínico visível.
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With the goal of ending viral hepatitis as a public health threat by 2030, the Regional Action Plan will provide an actionable framework for implementing evidence-based interventions at scale. It will be informed through strategic monitoring of the
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response, that must be equitable and sustainable and allow for innovations for acceleration and reaching out to all in need with health services. A major reduction in prices of newer drugs to potentially cure hepatitis C offers an added opportunity to work towards its elimination.
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WHO’s antiretroviral treatment (ART) clinic-based acquired drug resistance survey method yields robust estimates of HIV viral suppression and acquired HIV drug resistance in adults, children and adolescents taking both dolutegravir and non-doluteg
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ravir based regimens.
Results are used to inform ART programme decision making regarding optimal ART regimens and support evaluation of programme quality with respect to maximizing viral load suppression and minimizing emergence of resistance in people taking ART.
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3rd Edition – July 2017
www.msfaccess.org
Viral hepatitis is defined as inflammation of the liver cells due to viral infection. The burden of liver disease in South Africa is mostly underestimated as
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viral hepatitis, in particular chronic infection, is a silent and neglected cause of morbidity and mortality. However, the burden of disease is likely substantial given the prevalence of chronic viral hepatitis. This burden is further compounded by the lack of screening and access to care and treatment as well as inadequate disease surveillance, human and financial resources.
The National Guidelines for the Management of Viral Hepatitis were developed, with the purpose to:
inform healthcare workers in the public and private sectors about the disease, its epidemiology in South Africa and current methods of diagnosis and therapy
strengthen the healthcare response to viral hepatitis
empower communicable diseases workers and stakeholders to make informed decisions regarding appropriate and cost effective interventions
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This resource consists of technical guidelines for District Medical Officers, counselors and laboratory technicians for second-line antiretroviral therapy drugs, operational guidelines for pilot roll-out in two centres and laboratory guidelines for viral
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-load testing and standard operating procedures.
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This document provides guidelines and tools for monitoring the quality of outsourced viral load test results in India, defining processes and procedures as well as quality indicators and a monitorin
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g checklist for assuring quality of services. Annexes include reporting forms and checklists for monitoring visits.
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This document provides a systematic approach in developing a coordinated, standardized, reliable, efficient, cost-effective, and sustainable specimen transport and referral system to support IVHD and VL testing networks. This document provides technical and programmatic recommendations on the approp
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riate specimen storage and transportation of specimens for HIV VL and IVHD testing. Along with the national guidelines for specimen storage and transport, these standards should provide guidance on the creation or improvement of specimen referral networks and specimen transport systems. In addition, standard operating procedures (SOPs) targeting drivers and persons responsible for packing of specimens and results return are included in this document.
No publication year indicated in the document.
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The Zambia Population Based HIV impact assessment of 2016, reported the prevalence of viral hepatitis in Zambia as ranging between 5.6% among adults aged 15 to 59% in the general population, and 7.1% among HIV infected individuals. It is estimated t
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hat the majority of persons with chronic hepatitis B and/ or hepatitis C are unware of their infection and do not benefit from promotive, preventive and curative services designed to reduce onward transmission. Zambia introduced hepatitis B virus vaccine to the routine Under 5 vaccination schedule in 2005. Preliminary results from the ZAMPHIA indicate that hundreds of infections have been abated in children since then. However, its also clear that we continue to miss key opportunities to prevent transmission, diagnose and treat infections, prevent serious disease, and in many cases cure people. In addition, high risk groups inter alia health care workers still have limited access to the vaccine.
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The document describes the use of strategic information at various stages of the response in the context of strengthening broader health information systems. Strategic information can be defined as data collected at all service delivery and administrative levels to inform policy and programme decisi
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ons.
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