Health
The Role of HIV Viral Suppression in Improving Individual Health and Reducing Infection – World
overview
This policy brief describes key HIV viral load thresholds and viral load testing approaches that can be used to monitor the efficacy of antiretroviral therapy in people living with HIV. Clarify and elaborate on current therapy monitoring algorithms. Consolidated Guidelines for HIV Prevention, Testing, Treatment, Service Delivery and Monitoring: Recommendations for Public Health Approaches.
This information will help people living with HIV live healthy lives and keep HIV from spreading to others, and will help policy makers determine the optimal allocation of resources for viral load testing and communicate results.
Key messages include:
Suppression of the HIV virus is important for improving health, preventing sexually transmitted infections, and reducing perinatal transmission. There are three main categories of HIV viral load measurements. unsuppressed (>1000 copies/mL), suppressed (detected but ≤1000 copies/mL), and undetectable (no viral load detected by the test used). An HIV-infected person with an undetectable viral load using a combination of WHO prequalified samples and testing platforms, including dried blood samples, and who continues to take her medications as prescribed has zero risk of transmitting her HIV to her sexual partner. A person who is living with HIV, has a virally suppressed but detectable state, and is taking medications as prescribed has a near-zero or negligible risk of transmitting her HIV to a sexual partner. HIV viral load test results may provide motivation for adherence to treatment and the ultimate goal of non-detection. It is essential to emphasize and strengthen adherence counseling at the initiation of antiretroviral therapy and throughout treatment, including communicating the preventive benefits of viral load suppression to all people living with HIV. Current WHO prequalified tests, including alternative sample types such as point-of-care and dried blood stain samples, can support treatment program goals to accurately measure viral load results and report them as unsuppressed, suppressed, or undetectable.
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