Update on the june 6 and 7 2012 who treatment optimization diagnostics workstream meeting
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Update on the June 6 and 7, 2012 WHO Treatment Optimization Diagnostics Workstream meeting. Joseph Perriëns World Health Organization Geneva. LABORATORY MONITORING OF ART IN ADULTS WHO 2010 "GUIDING PRINCIPLES".

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Update on the june 6 and 7 2012 who treatment optimization diagnostics workstream meeting

Update on the June 6 and 7, 2012 WHO Treatment Optimization Diagnostics Workstreammeeting

Joseph Perriëns

World Health Organization

Geneva


Laboratory monitoring of art in adults who 2010 guiding principles
LABORATORY MONITORING OF ART IN ADULTS WHO 2010 "GUIDING PRINCIPLES"

These recommendations are being re-assessed as part of the development of WHO's 2013 consolidated guidelines on ART

Laboratory monitoring is not a prerequisite for the initiation of ART.

CD4 and viral load testing are not essential for monitoring patients on ART.

Symptom-directed laboratory monitoring for safety and toxicity is recommended for those on ART.

If resources permit, use viral load in a targeted approach to confirm suspected treatment failure based on immunological and/or clinical criteria.

If resources permit, use viral load in a routine approach, measured every 6 months, with the objective of detecting failure earlier than would be the case if immunological and/or clinical criteria were used to define failure.

International AIDS Conference 2012


Diagnosis of hiv infection and monitoring art in infants and young children who 2010
DIAGNOSIS OF HIV INFECTION AND MONITORING ART IN INFANTS AND YOUNG CHILDREN – WHO 2010

These recommendations are being re-assessed as part of the development of WHO's 2013 consolidated guidelines on ART

It is strongly recommended that all HIV-exposed infants have HIV virological testing at 4 – 6 weeks of age or at the earliest opportunity thereafter.

The following assays (and respective specimen types) are strongly recommended for use: HIV DNA on whole blood specimen or DBS, HIV RNA on plasma or DBS, Up24 Ag on plasma or DBS. "Exercise caution in interpreting negative results when using HIV RNA or Up24 if infant is established on ART."

In infants with an initial positive virological test result, it is strongly recommended that …/…a second specimen be collected to confirm the initial positive virological test result.

HIV VL measurement in monitoring treatment: "As required or symptom directed"

International AIDS Conference 2012


Objectives of the meeting
Objectives of the meeting AND YOUNG CHILDREN – WHO 2010

To articulate consensus on technologies which need to be deployed nowin HIV programs

To identify which technologies need to be developed in short, medium and longer term

International AIDS Conference 2012


Technology deployment levels
Technology deployment levels AND YOUNG CHILDREN – WHO 2010

InternationalAIDS Conference 2012


International AIDS Conference 2012 AND YOUNG CHILDREN – WHO 2010


International AIDS Conference 2012 AND YOUNG CHILDREN – WHO 2010


International AIDS Conference 2012 AND YOUNG CHILDREN – WHO 2010


Viral load and early diagnosis in infants eid
Viral load and Early diagnosis in infants (EID AND YOUNG CHILDREN – WHO 2010)

  • Short term needs

  • POC EID and VL testsfor use in health centre/office and first referral lab settings

  • Medium/longer term needs

  • Instrument free POC test for use in community

  • Combo tests (CD4/VL)

    • Semi-automated devices for deployment at level 2 and up.

International AIDS Conference 2012


Hiv drug resistance
HIV Drug Resistance AND YOUNG CHILDREN – WHO 2010

7/19/2012 Mention of any product or manufacturer in this presentation should not be interpreted as their endorsement by WHO

International AIDS Conference 2012


International AIDS Conference 2012 AND YOUNG CHILDREN – WHO 2010


  • Medium AND YOUNG CHILDREN – WHO 2010and longer term needs

  • Combo tests (CD4/VL)

  • Home sample collection tools

International AIDS Conference 2012


Acknowledgements
Acknowledgements AND YOUNG CHILDREN – WHO 2010

International AIDS Conference 2012


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