ArticleAIDS (London, England)2012
Viral load monitoring of antiretroviral therapy, cohort viral load and HIV transmission in Southern Africa: a mathematical modelling analysis.
Article in AIDS (London, England), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed.
- Success rates and adherence to antiretroviral therapy among treatment-naïve patients in Davao City, Philippines: A ten-year retrospective cohort study.Dialogues in health · 2024Article
- An integrated microfluidic platform for nucleic acid testing.Microsystems & nanoengineering · 2024Article
- ATR-FTIR spectroscopy in blood plasma combined with multivariate analysis to detect HIV infection in pregnant women.Scientific reports · 2020Article
- Should we wait or not? The preferable option for patients with stage IV oral cancer in COVID-19 pandemic.Head & neck · 2020Article
- Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives.Diagnostics (Basel, Switzerland) · 2020Article
- The role of HIV viral load in mathematical models of HIV transmission and treatment: a review.BMJ global health · 2020Review
- Routine viral load monitoring and enhanced adherence counselling at a public ART centre in Mumbai, India.PloS one · 2020Article
- Evaluation of a health system intervention to improve virological management in an antiretroviral programme at a municipal clinic in central Durban.Southern African journal of HIV medicine · 2019Article
- A Markov Model to Estimate Mortality Due to HIV/AIDS Using Viral Load Levels-Based States and CD4 Cell Counts: A Principal Component Analysis Approach.Infectious diseases and therapy · 2018Article
- Clinical Benefits and Cost-Effectiveness of Laboratory Monitoring Strategies to Guide Antiretroviral Treatment Switching in India.AIDS research and human retroviruses · 2018Article
- The Effect of Monitoring Viral Load and Tracing Patients Lost to Follow-up on the Course of the HIV Epidemic in Malawi: A Mathematical Model.Open forum infectious diseases · 2018Article
- Segmented polynomials for incidence rate estimation from prevalence data.Statistics in medicine · 2017Article
- The need for second-line antiretroviral therapy in adults in sub-Saharan Africa up to 2030: a mathematical modelling study.The lancet. HIV · 2016Article
- Article
- Monitoring of HIV treatment in seven countries in the WHO Region of the Americas.Bulletin of the World Health Organization · 2015Article
- gems: An R Package for Simulating from Disease Progression Models.Journal of statistical software · 2015Article
- Article
- Viral load versus CD4⁺ monitoring and 5-year outcomes of antiretroviral therapy in HIV-positive children in Southern Africa: a cohort-based modelling study.AIDS (London, England) · 2014Article
- Delayed switch of antiretroviral therapy after virologic failure associated with elevated mortality among HIV-infected adults in Africa.AIDS (London, England) · 2014Observational
- Tracing of patients lost to follow-up and HIV transmission: mathematical modeling study based on 2 large ART programs in Malawi.Journal of acquired immune deficiency syndromes (1999) · 2014Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
objectivesIn low-income settings, treatment failure is often identified using CD4 cell count monitoring. Consequently, patients remain on a failing regimen, resulting in a higher risk of transmission. We investigated the benefit of routine viral load monitoring for reducing HIV transmission.
designMathematical model.
methodsWe developed a stochastic mathematical model representing the course of individual viral load, immunological response and survival in a cohort of 1000 HIV-infected patients receiving antiretroviral therapy (ART) in southern Africa. We calculated cohort viral load (CVL; sum of individual viral loads) and used a mathematical relationship between individual viral load values and transmission probability to estimate the number of new HIV infections. Our model was parameterized with data from the International epidemiologic Databases to Evaluate AIDS Southern African collaboration. Sensitivity analyses were performed to assess the validity of the results in a universal 'test and treat' scenario, wherein patients start ART earlier after HIV infection.
resultsIf CD4 cell count alone was regularly monitored, the CVL was 2.6 × 10 copies/ml and the treated patients transmitted on average 6.3 infections each year. With routine viral load monitoring, both CVL and transmissions were reduced by 31% to 1.7 × 10 copies/ml and 4.3 transmissions, respectively. The relative reduction of 31% between monitoring strategies remained similar for different scenarios.
conclusionAlthough routine viral load monitoring enhances the preventive effect of ART, the provision of ART to everyone in need should remain the highest priority.
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