Table 2 Reported uptake of viral load monitoring, confirmation of treatment failure and switching treatment regimen rates from included studies
First author, year | Follow-up/ Observation period | Notes | ||||
|---|---|---|---|---|---|---|
Initial VL monitoring a (IVL) | Follow-up VL monitoring b (FUVL) | Confirmation of virological failure c | Switching to 2nd line ART d | |||
Apollo, T.; 2021 [36] | 2004–2018 | 99,902/392,832 (25.4%) | 6,689/17,970 (37.2%) | 4,086/6,689 (61.1%) | 1,749/4,086 (42.8%) | - IVL (%) of patients on ART for > = 12 months who had at least one VL test done - Details of EAC (after initial elevated VL ≥ 1000 copies/ml) not provided |
Brazier, E.; 2021 [49] | 6 months | 34,570/292,380 (11.8%) | - | - | - | - Adults (> 19 years): 31,147/260,735 (11.9%) Adolescents (10–19 years): 1,295/11,619 (11.1%) Children (< 10 years): 2128/20,026 (10.6%) - Coverage before and after Treat All policy: Adults (9.1% & 34.7%); Adolescents (9.1% & 26.5%); Children (9.9% & 22.6%) |
Haghighat, R.; 2021 [28] | 12 months | 449/951 (47.2%) | - | - | - | − 951/1,080 have clinical record available; 878/951 (92.3%) had at least one VL result recorded. Among those with any VL data, 51.1% (449/878) and 75.4% (662/878) had their most recent VL recorded in past 12 months and 24 months, respectively. |
24 months | 662/951 (69.6%) | - | - | - | ||
Woldesenbet, S. A.; 2021 [29] | 2019 | 6,542/8,112 (81.7%) | - | - | - | - VL testing recommended for all HIV (+) pregnant women at delivery, on ART at 1st ANC visit or 3 months after ART initiation |
Herce, M.E.; 2020 [50] | 6 months | 269/346 (78%) | - | - | - | - IVL: % individuals with completed VL monitoring scheduled at 6- and 12-months follow-up visits |
12 months | 96/149 (64%) | - | - | - | ||
Mshweshwe-Pakela, N.; 2020 [30] | 6 months | 455/710 (64.1%) | - | - | - | VL test done between 4 and 8 months after ART initiation |
Nakalega, R.; 2020 [47] | 12 months | 279/414 (67.4%) | - | - | - | - VL testing done at 6 months after ART initiation and 12 months thereafter at national reference Lab |
Opito, R.; 2020 [48] | 12 months | 221/422 (52.4%) | - | - | - | VL monitoring assessed by the presence of VL slip captured in medical record within 12 months of enrolment on test and treat |
Ya, S.S.T.; 2020 [53] | 6 months | 952/1,892 (50.3%) | 88/106 (83%) | 23/88 (26%) | 9/23 (39.1%) | - PLHIV started ART between: (a) 1/1/2016 and 30/6/2017 were scheduled for 12 VL testing; (b) 1/7/2017 and 31/12/2017 were scheduled for 6 months VL testing due to change in policy - Details of EAC (after initial elevated VL ≥ 1000 copies/ml) not provided |
12 months | 3,476/6,816 (51%) | 273/346 (78.9%) | 115/273 (42.1%) | 98/115 (85%) | ||
Moudachirou, R.; 2020 [43] | 12 months | 118/306 (38.5%) | - | - | - | Yearly VL test done at closest health facility 9–18 months after transfer to PODIs (decentralized community ART centres) |
Iwuji, C.C.;2020 [22] | 6 months | 9,861/24,199 (40.7%) | - | - | - | - IVL time windows: 5–9 months for 6 months and +/- 3 months for 12 & 24 months after ART initiation - FUVL done within 6 months of the initial elevated VL - VL monitoring coverage varied across sites. Optimal monitoring to 12, 24 months were 12%, 6%, respectively - Details of EAC (after initial elevated VL ≥ 1000 copies/ml) not provided |
12 months | 7,765/22,807 (34.0%) | - | - | - | ||
24 months | 4,334/16,965 (25.5%) | 658/2135 (30.8%) | 408/658 (62%) | 141/408 (34.5%) | ||
Nguyen, T.A.; 2020 [55] | 6 months | 397/537 (73.9%) | 15/59 (25.4%) | 11/15 (74.4%) | - | - DBS samples collected during clinic visit 4–10 months after ART initiation - Details of EAC (after initial elevated VL ≥ 1000 copies/ml) not provided |
Kehoe, K.; 2020 [23] | 4 months | 5,340/6,547 (82%) | - | - | - | - Routine VL required at 4 months after entering adherence club (AC) and annually thereafter - Details of EAC (after initial elevated VL ≥ 1000 copies/ml) not provided |
16 months | 3,171/3,856 (82%) | - | - | - | ||
28 months | 1,841/2,170 (85%) | - | - | - | ||
40 months | 884/1,061 (83%) | - | - | - | ||
2011–17 | 7,136/8,058 (89%) | 291/441 (66%) | 150/291 (52%) | - Proportion of patients with at least one VL test after AC entry - FUVL done within 12 months after initial elevated VL | ||
Thinn, K.K.; 2019 [52] | 24 months | 288/498 (57.8%) | 8/25 (32%) | 6/8 (75%) | - | - Proportions of first routine VL test done within 6–9 months, 9–15 months and after 15 months of ART initiation were: 56/498 (11.2%); 113/498 (22.7%) and 119/498 (23.9%); respectively - Details of EAC (after initial elevated VL ≥ 1000 copies/ml) not provided |
Tapera, T.; 2019 [33] | 12 months | 1,044/1,153 (91%) | - | - | - | - VL test conducted 6–12 months after ART initiation |
Nyakura, J.; 2019 [34] | 6 months | 354/1,112 (32%) - Hospitals: 146/327 (44.6%) - Clinics: 208/785 (26.5%) | 13/20 (65%) | - | - | - VL data collected at health facilities up to 6 months post delivery - Proportions of women with VL test done before, at or after delivery, and “unknown time” were: 113/1112 (10%); 124/1,112 (11%) and 117/1,112 (10.5%) - Details of EAC (after initial elevated VL ≥ 1000 copies/ml) not provided |
Nyagadza, B.; 2019 [35] | 12 months | 5,966/9,456 (63%) | 281/622 (45.2%) | 233/281 (83%) | 108/233 (46.4%) | - IVL: patients eligible for VL monitoring who had at least one VL test done during the observation period - FUVL: 23 (8%) had a follow-up VL within 3 months, another 153 (56%) within 3–6 months of initial high VL − 31% of patients with IVL ≥ 1000 copies/ml have at least 1 EAC session documented |
Nicholas, S.; 2019 [42] | 48 months | 17,832/21,004 (85%) - Hospitals: 5,112/6,237 (82%) - Clinics: 13,060/15,163 (86%) | 1,277/1,544 (83%) - Hospitals: 79%; - Clinics: 84%; | 901/1,277 (70.6%) | 434/540 (80%) - Hospitals: 67%; - Clinics: 86%; | - IVL: First VL test at 6 months after ART initiation - Patients eligible for 2nd line ART after having 2 consecutive FUVLs (3 months apart) of ≥ 1000 copies/ml - Details of EAC (after initial elevated VL ≥ 1000 copies/ml) not provided |
Ndagijimana Ntwali, J. D.; 2019 [37] | 2013 | 39/152 (25.6%) | - | - | - | - IVL: 12-month VL uptake among patients active on ART - FUVL: coverage among patients active on ART 6 months after their high initial VL - Details of EAC (after initial elevated VL ≥ 1000 copies/ml) not provided |
2014 | 195/312 (62.5%) | - | - | - | ||
2015 | 347/494 (70.2%) | - | - | - | ||
2016 | 510/547 (93.2%) | - | - | - | ||
2013–16 | 698/775 (90%) | 103/117 (88%); | 41/103 (40%) | 26/41 (63.4%) | ||
Le Roux, K. W.; 2019 [24] | 6 months | 480/579 (83%) | - | - | - | - Outcomes of an intervention program to encourage on-time VL testing with reduced clinic visits - VL done within 2–7 months & within 12 months of ART initiation |
12 months | 536/579 (92.6%) | - | - | - | ||
Euvrad, J.; 2019 [25] | 60 months | 18,450/21,991 (84%) | - | - | - | Routine VL done within window periods: 3–9 months for 1st VL; 9–18 months for second VL; and +/- 6 months for every annual VL expected thereafter |
Cisse, A. M.; 2019 [41] | 2015 | 2% (n/N not reported) | - | - | - | - Patients on ART who have at least one documented VL during follow-up - Median time on ART: 21 months (IQR: 1-129) |
Namale, G; 2019 [46] | 2015–16 | 477/584 (81.7%) | - VL testing done 6 months after ART initiation and 12 months thereafter | |||
Sunpath, H.; 2018 [31] | 6 months | 4,889/5,196 (94%) | VL testing rate at 6 and 12 months of an intervention program to improve VL monitoring (baseline rate: 63% (547/864) | |||
12 months | 10,640/11,096 (96%) | |||||
Moyo, F.; 2018 [32] | 2016 | 110/233 (47.2%) | - | - | - | - IVL: % of women (HIV infected mother) received ART who had a documented VL result |
Janurag, P. P.; 2018 [54] | 12 months | 325/457 (71%) | - | - | - | First VL test done around 6 months after ART initiation |
Kadima, J.; 2018 [44] | 12 months | 1,190/1,272 (93.6%) | 66/98 (67.3%) | 51/66 (77.3%) | 9/51 (17.6%) | - Initial routine VL defined as most recent VL received Jun 2014 – May 2015 − 98 cases randomly selected from 442 patients with elevated VL (VL ≥ 1000 copies/ml) - No child received a FUVL within 3 months, only 9/66 (14%) had a FUVL within 6 months of initial elevated VL - Details of EAC (after initial elevated VL ≥ 1000 copies/ml) not provided |
Etoori, D.; 2018 [40] | 24 months | 251/337 (67.3%) | - | - | - | - First VL test done 6–12 months after ART initiation |
Copelyn, J.; 2018 [26] | 6 months | 60/75 (80%) | - | - | - | Documented VLs at 6 & 12 months after down-referral to decentralized care |
12 months | 54/75 (72%) | - | - | - | ||
Amzel, A.; 2018 [39] | 12 months | 5,365/11,337 (47%) | - | - | - | - Proxy VL coverage indicator: Numerator: Number of patients with a documented VL. Denominator: Number of patients on ART at study sites as of 30/9/2017 |
Tsondai, P.R.; 2017 [27] | 4 months | 2,782/3,216 (86.5%) | - | - | - | - VL testing required at 4 months after AC enrolment and every 12 months thereafter |
16 months | 1,563/1,846 (84.7%) | - | - | - | ||
28 months | 490/615 (79.7%) | - | - | - | ||
Swannet, S.; 2017 [45] | 24 months | 17,236/34,514 (50%) | 1,095/2,600 (42%) | 678/1,095 (62%) | 212/678 (31.3%) | - IVL: First VL test done during the observation period - VL cut-off: 3000 copies/ml - Only 50% (339/678) patients with 2 consecutive VL ≥ 3000 copies/ml were proposed and approved for 2nd -line ART - Details of EAC (after initial elevated VL ≥ 1000 copies/ml) not provided |
Kyaw, N.T.; 2017 [51] | 2005–15 | 7,888/23,248 (34%) | - | - | 762/1,032 (74%) | - Target VL monitoring was implemented - IVL: proportion of patient who tested for VL among PLHIV on ART ≥ 6 months |
Cyamatare Rwabukwisi, F.; 2016 [38] | 60 months | 235/277 (84.8%) | 25/34 (73%) | - | - | - IVL: a documented VL result within 5 years of ART initiation - FUVL: an additional VL after a VL of ≥ 1000 copies/ml within 5 years of ART initiation - Details of EAC (after initial elevated VL ≥ 1000 copies/ml) not provided |