Diagnostics and Laboratory Technology

'Consultation on Laboratory Services for Monitoring HIV Anti-Retroviral Therapy in Resource-Limited Settings' - 13-15 December 2004, held in Geneva.

One clear outcome from the introduction of WHO's '3 by 5' initiative and the consequent expansion of anti-retroviral therapy (ARV) dispensing programmes, is the need for appropriate laboratory support. Patients on ARV require regular laboratory monitoring to ensure the effectiveness of their drug regimen. For example, if a patient is not monitored, the risk of development of drug-resistant strains is greatly increased.

The meeting was jointly convened by the Department of Essential Health Technologies and the Department of HIV/AIDS to reach technical and operational recommendations for scale-up of laboratory services in resource-limited settings where monitoring of HIV anti-retroviral therapy is required. The meeting bought together clinicians and laboratory experts in order to reach some consensus.

Tests for initial diagnosis of HIV infection, diagnosis of opportunistic infections and other basic laboratory tests (such as haematology) plus CD4 T-cell enumeration technologies for determination of immune status and patient response to ARV were discussed. The minimum laboratory tests and equipment requirements were produced for the various health care levels which range from the top level centralized reference laboratory through to VCT centres.

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