Role of Laboratory testing in the Cascade of HIV Diagnosis, Prevention and Treatment
Dr.Arvind Natarajan, MD(Microbiology)
Human immunodeficiency virus (HIV) is the major contributor to global burden of diseases. Worldwide, approximately 34 million people are infected with HIV of which 2.1 million people are residing in India. 20% of infected people are unaware of their diagnosis. Improved methods of HIV testing could decrease this number.
Microbiology Laboratory testing plays a pivotal role in the cascade of HIV diagnosis, prevention and treatment services. Laboratory services are not just confined to HIV testing, they guide the physicians on clinical decision making in determining the eligibility for HAART drugs, monitoring the viral loads , detecting drug resistance, predicting the prognosis of the disease and outcome.
HIV diagnostic testing has come a long way since its inception in the early 1980s. There are many assays available currently to detect HIV. Point of Care tests have become increasingly popular in the recent times as they are simple, cost effective & provide rapid results onsite. The performance of all assays warrants adherence to good laboratory quality control practices to provide confirmation in case of positive or indeterminate results.
All Microbiology laboratories which offer HIV testing services should follow the WHO principle of 5 C’s – consent, confidentiality, counselling, correct test results and connection to care and treatment as a good laboratory practice.