HIV/AIDS

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Antiretroviral therapy: laboratory testing

Afghanistan

• International Journal of STD & AIDS
  • Gaps in the continuum of care among people living with HIV in Afghanistan [2022]

Africa

• PLoS ONE
  • HIV virologic failure and its predictors among HIV-infected adults on antiretroviral therapy in the African Cohort Study [2019]

Americas

• Journal of the International AIDS Society
  • A picture is worth a thousand words: maps of HIV indicators to inform research, programs, and policy from NA-ACCORD and CCASAnet clinical cohorts [2016]

Asia

• HIV Medicine
  • Same-day and rapid initiation of antiretroviral therapy in people living with HIV in Asia. How far have we come? [2022]

• IeDEA
  • Virological failure and treatment switch after ART initiation among people living with HIV with and without routine viral load monitoring in Asia [2022]
  • An expanded HIV care cascade: ART uptake, viral load suppression and comorbidity monitoring among adults living with HIV in Asia [2020]

Asia-Pacific

• IeDEA
  • CD4/CD8 Ratio Recovery Among People Living With HIV Starting With First-Line Integrase Strand Transfer Inhibitors: A Prospective Regional Cohort Analysis [2023]

• International Journal of STD & AIDS
  • Trends in CD4 count response to first-line antiretroviral treatment in HIV-positive patients from Asia, 2003–2013: TAHOD-LITE [2017]

Australia

• Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine
  • Laboratory Testing

Barbados

• PLoS ONE
  • Ten Year Trends in Community HIV Viral Load in Barbados: Implications for Treatment as Prevention [2013]

Belgium

• HIV Medicine
  • Late presentation to HIV testing is overestimated when based on the consensus definition [2015]

Botswana

• Lancet HIV
  • Botswana’s Progress Toward Achieving the 2020 UNAIDS 90–90–90 Antiretroviral Treatment and Virologic Suppression Goals: Results of a Population-Based Survey [2016]

Brazil

• Medicine
  • Sociodemographic determinants of attrition in the HIV continuum of care in Brazil, in 2016 [2018]

• PLoS ONE
  • Time from treatment initiation to HIV viral suppression in public care facilities in Brazil: A nationwide linked databases cohort [2024]

• Revista Brasileira de Epidemiologia
  • Community viral load of HIV in Brazil, 2007 - 2011: potential impact of highly active antiretroviral therapy (HAART) in reducing new infections [2016]

Cambodia

• Frontiers in Public Health
  • Positive Virological Outcomes of HIV-Infected Patients on Protease Inhibitor-Based Second-Line Regimen in Cambodia: The ANRS 12276 2PICAM Study [2018]

Cameroon

• BMC Public Health
  • Optimal starting point for antiretroviral HIV treatment in a town in Cameroon: a randomised controlled study [2014]

Canada

• Canadian Agency for Drugs and Technologies in Health
  • Risk of Sexual Transmission of HIV With Antiretroviral Therapy and Variable or Suppressed Viral Load [2023]

• Canadian Journal of Infectious Diseases & Medical Microbiology
  • HIV-1 tropism testing and clinical management of CCR5 antagonists: Quebec review and recommendations [2013]

• Journal of the International AIDS Society
  • Late initiation of combination antiretroviral therapy in Canada: a call for a national public health strategy to improve engagement in HIV care [2015]

East Africa

• HIV Research & Clinical Practice
  • Prevalence and predictors of virological failure among the people living with HIV on antiretroviral treatment in East Africa: evidence from a systematic review with meta-analysis and meta-regression of published studies from 2016 to 2023 [2025]

Eswatini

• Centers for Disease Control and Prevention
  • Peer-Delivered Linkage Case Management and Same-Day ART Initiation for Men and Young Persons with HIV Infection — Eswatini, 2015–2017 [2018]

• Journal of Acquired Immune Deficiency Syndromes
  • Changing Antiretroviral Eligibility Criteria: Impact on the Number and Proportion of Adults Requiring Treatment in Swaziland [2016]

• PLoS ONE
  • Cost-effectiveness of a combination strategy to enhance the HIV care continuum in Swaziland: Link4Health [2018]

Ethiopia

• BMJ Open
  • Virological failure and associated factors among patients receiving anti-retroviral therapy in Ethiopia: A systematic review and meta-analysis [2024]

Ethiopia, Guyana, India

• World Health Organization
  • Country experiences in implementing patient monitoring systems for HIV care and antiretroviral therapy in Ethiopia, Guyana and India : an overview of best practices and lessons learned [2010]

Europe

• HIV Medicine
  • Late presentation of HIV infection: a consensus definition [2011]

Germany

• BMC Public Health
  • Everything counts - a method to determine viral suppression among people living with HIV using longitudinal data for the HIV care continuum - results of two large, German, multi-center real-life cohort studies over 20 years (1999–2018) [2021]

Haiti

• PLoS ONE
  • Risk factors for delayed viral suppression on first-line antiretroviral therapy among persons living with HIV in Haiti, 2013–2017 [2020]
  • Trends in CD4 Count Testing, Retention in Pre-ART Care, and ART Initiation Rates over the First Decade of Expansion of HIV Services in Haiti [2016]

India

• AIDS Research and Human Retroviruses
  • Clinical Benefits and Cost-Effectiveness of Laboratory Monitoring Strategies to Guide Antiretroviral Treatment Switching in India [2018]

• Journal of the International AIDS Society
  • Economic and epidemiological impact of early antiretroviral therapy initiation in India [2015]

• Ministry of Health and Family Welfare India
  • National Operational Guidelines for Viral Load Testing [2018]

International

• AIDS and Behavior
  • Psychosocial Interventions to Promote Undetectable HIV Viral Loads: A Systematic Review of Randomized Clinical Trials [2022]

• Clinical Infectious Diseases
  • Effects of National Adoption of Treat-All Guidelines on Pre-Antiretroviral Therapy (ART) CD4 Testing and Viral Load Monitoring After ART initiation: A Regression Discontinuity Analysis [2021]

• Cochrane Database of Systematic Reviews
  • Point-of-care viral load tests to detect high HIV viral load in people living with HIV/AIDS attending health facilities [2022]

• Emerging Microbes & Infections
  • The prevalence of low-level viraemia and its association with virological failure in people living with HIV: a systematic review and meta-analysis [2025]

• HIV Medicine
  • Point-of-care nucleic acid testing - a step forward in controlling the HIV epidemic: A review [2025]

• IeDEA
  • Global estimates of viral suppression in children and adolescents and adults on antiretroviral therapy adjusted for missing viral load measurements: a multiregional, retrospective cohort study in 31 countries [2021]

• Journal of Infection
  • Clinical events associated with poor CD4+ T-cell recovery in people living with HIV following ART: A systematic review and meta-analysis [2025]

• Journal of the International AIDS Society
  • Community-driven demand creation for the use of routine viral load testing: a model to scale up routine viral load testing [2017]

• Lancet
  • Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies [2009]

• Lancet Global Health
  • Cost-effectiveness of different strategies to monitor adults on antiretroviral treatment: a combined analysis of three mathematical models [2014]

• PLoS Medicine
  • HIV treatment eligibility expansion and timely antiretroviral treatment initiation following enrollment in HIV care: A metaregression analysis of programmatic data from 22 countries [2018]

• Scientific Reports
  • Use of laboratory-developed assays in global HIV-1 treatment-monitoring and research [2023]

• Sexually Transmitted Infections
  • Managing low-level HIV viraemia in antiretroviral therapy: a systematic review and meta-analysis [2024]

• UNAIDS
  • Undetectable = untransmittable — Public health and HIV viral load suppression [2024]
  • Understanding measures of progress towards the 95–95–95 HIV testing, treatment and viral suppression targets [2024]
  • Universal test and connect: brief considerations [2021]
  • Public health and HIV viral load suppression [2017]
  • The need for routine viral load testing [2016]

Italy

• Sexually Transmitted Infections
  • Management of low-level HIV viremia during antiretroviral therapy: Delphi consensus statement and appraisal of the evidence [2024]

Ivory Coast

• Clinical Infectious Diseases
  • Laboratory Monitoring of Antiretroviral Therapy for HIV Infection: Cost-Effectiveness and Budget Impact of Current and Novel Strategies [2016]

Kenya

• PLoS ONE
  • Positive Predictive Value of the WHO Clinical and Immunologic Criteria to Predict Viral Load Failure among Adults on First, or Second-Line Antiretroviral Therapy in Kenya [2016]
  • Detectable HIV Viral Load in Kenya: Data from a Population-Based Survey [2016]

Kenya, Uganda

• PLoS ONE
  • Trends and Determinants of Antiretroviral Therapy Patient Monitoring Practices in Kenya and Uganda [2015]

Low and middle income countries

• BMC Health Services Research
  • Acceptability and feasibility of point-of-care CD4 testing on HIV continuum of care in low and middle income countries: a systematic review [2016]

• BMC Medicine
  • Feasibility of HIV point-of-care tests for resource-limited settings: challenges and solutions [2014]

• BMC Public Health
  • Viral load monitoring for people living with HIV in the era of test and treat: progress made and challenges ahead - a systematic review [2022]

• Centers for Disease Control and Prevention
  • Notes from the Field: Impact of the COVID-19 Response on Scale-Up of HIV Viral Load Testing — PEPFAR-Supported Countries, January–June 2020 [2021]
  • Trends in Prevalence of Advanced HIV Disease at Antiretroviral Therapy Enrollment — 10 Countries, 2004–2015 [2017]

• Clinical Infectious Diseases
  • Scale-up of Routine Viral Load Testing in Resource-Poor Settings: Current and Future Implementation Challenges [2016]
  • Long-term Virological Outcomes of First-Line Antiretroviral Therapy for HIV-1 in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis [2015]

• Journal of the International AIDS Society
  • Cost-effectiveness of routine viral load monitoring in low- and middle-income countries: a systematic review [2017]

• Médecins Sans Frontières
  • Challenges and opportunities for the implementation of virological testing in resource-limited settings [2012]

Malawi

• Tropical Medicine & International Health
  • Factors associated with HIV viral suppression among children and adults receiving antiretroviral therapy in Malawi in 2021: Evidence from the Laboratory Management Information System [2022]

Mexico

• PLoS ONE
  • CD4 Counts at Entry to HIV Care in Mexico for Patients under the “Universal Antiretroviral Treatment Program for the Uninsured Population,” 2007–2014 [2016]

Middle East, North Africa

• World Journal of Virology
  • Early initiation of antiretroviral treatment: Challenges in the Middle East and North Africa [2015]

Mozambique

• PLoS ONE
  • The Clinical and Economic Impact of Point-of-Care CD4 Testing in Mozambique and Other Resource-Limited Settings: A Cost-Effectiveness Analysis [2014]

Myanmar

• PLoS ONE
  • Viraemic-time predicts mortality among people living with HIV on second-line antiretroviral treatment in Myanmar: A retrospective cohort study [2022]

Netherlands

• Medicine
  • Longitudinal virological outcomes and factors associated with virological failure in behaviorally HIV-infected young adults on combination antiretroviral treatment in the Netherlands, 2000 to 2015 [2019]

Nigeria

• PLoS ONE
  • Effect of Test and Treat on clinical outcomes in Nigeria: A national retrospective study [2023]
  • Evaluation of the clinical outcomes of the Test and Treat strategy to implement Treat All in Nigeria: Results from the Nigeria Multi-Center ART Study [2019]

North America, Northern Europe

• Nature Communications
  • Time to HIV viral rebound and frequency of post-treatment control after analytical interruption of antiretroviral therapy: an individual data-based meta-analysis of 24 prospective studies [2025]

Republic of Korea

• Infection & Chemotherapy
  • Trend of CD4+ Cell Counts at Diagnosis and Initiation of Highly Active Antiretroviral Therapy (HAART): Korea HIV/AIDS Cohort Study, 1992-2015 [2017]

Rwanda

• AIDS
  • Trends in and correlates of CD4+ cell count at antiretroviral therapy initiation after changes in national ART guidelines in Rwanda [2015]

Saudi Arabia

• Journal of Infection in Developing Countries
  • Antiretroviral therapy, CD4, viral load, and disease stage in HIV patients in Saudi Arabia: a 2001–2013 cross-sectional study [2015]

South Africa

• BMC Infectious Diseases
  • Change of treatment guidelines and evolution of ART initiation in rural South Africa: data of a large HIV care and treatment programme [2015]

• PLoS Medicine
  • Variation in HIV care and treatment outcomes by facility in South Africa, 2011–2015: A cohort study [2021]

• PLoS ONE
  • Comparative cost analysis of point-of-care versus laboratory-based testing to initiate and monitor HIV treatment in South Africa [2019]

South Sudan

• International Journal of STD & AIDS
  • Viral load scale-up in south Sudan: Strategic implementation of tools to monitor HIV treatment success among people living with HIV [2022]

Spain

• GESIDA
  • Executive summary of the GeSIDA consensus document on control and monitoring of HIV-infected patients [2019]

• PLoS ONE
  • Economic and epidemiologic impact of guidelines for early ART initiation irrespective of CD4 count in Spain [2018]

Sub-Saharan Africa

• AIDS
  • How do different eligibility guidelines for antiretroviral therapy affect the cost–effectiveness of routine viral load testing in sub-Saharan Africa? [2014]

• BMC Infectious Diseases
  • Viral load suppression rate of third-line antiretroviral therapy and its association with gender among HIV patients after second-line treatment failure in Africa: a systematic review and meta-analysis [2025]

• BMC Public Health
  • The viral load monitoring cascade in HIV treatment programmes in sub-Saharan Africa: a systematic review [2024]

• Centers for Disease Control and Prevention
  • HIV Viral Load Monitoring Among Patients Receiving Antiretroviral Therapy — Eight Sub-Saharan Africa Countries, 2013–2018 [2021]
  • Progress with Scale-Up of HIV Viral Load Monitoring — Seven Sub-Saharan African Countries, January 2015–June 2016 [2016]

• IeDEA
  • Viral Load Status Before Switching to Dolutegravir-Containing Antiretroviral Therapy and Associations With Human Immunodeficiency Virus Treatment Outcomes in Sub-Saharan Africa [2022]

• Journal of the International AIDS Society
  • Interventions to improve the rate or timing of initiation of antiretroviral therapy for HIV in sub-Saharan Africa: meta-analyses of effectiveness [2016]
  • Diagnostic accuracy of the WHO clinical staging system for defining eligibility for ART in sub-Saharan Africa: a systematic review and meta-analysis [2014]

• Microbiology Spectrum
  • Point of Care CD4 Testing in National Household Surveys - Results and Quality Indicators from Eleven Population-Based HIV Impact Assessment (PHIA) Surveys [2023]

• Open Forum Infectious Diseases
  • Detection of HIV Virologic Failure and Switch to Second-Line Therapy: A Systematic Review and Meta-analysis of Data From Sub-Saharan Africa [2022]

• PLoS Medicine
  • Changes in rapid HIV treatment initiation after national “treat all” policy adoption in 6 sub-Saharan African countries: Regression discontinuity analysis [2019]
  • Accelerating the Uptake and Timing of Antiretroviral Therapy Initiation in Sub-Saharan Africa: An Operations Research Agenda [2016]

• PLoS ONE
  • The epidemiology of HIV population viral load in twelve sub-Saharan African countries [2023]
  • Progress in scale up of HIV viral load testing in select sub-Saharan African countries 2016-2018 [2023]
  • Impact of "test and treat" recommendations on eligibility for antiretroviral treatment: Cross sectional population survey data from three high HIV prevalence countries [2018]

• Southern African Journal of HIV Medicine
  • The evolution and adoption of World Health Organization policy guidelines on antiretroviral therapy initiation in sub-Saharan Africa: A scoping review [2020]

Taiwan

• Journal of Microbiology, Immunology and Infection
  • Impact of initiation of combination antiretroviral therapy according to the WHO recommendations on the survival of HIV-positive patients in Taiwan [2019]

Tanzania

• PLoS ONE
  • Impact of Age and Sex on CD4+ Cell Count Trajectories following Treatment Initiation: An Analysis of the Tanzanian HIV Treatment Database [2016]

Uganda

• BMC Infectious Diseases
  • Universal test, treat, and keep: improving ART retention is key in cost-effective HIV control in Uganda [2017]

• BMC Public Health
  • Cost-effectiveness of early initiation of first-line combination antiretroviral therapy in Uganda [2012]

United Kingdom

• AIDS
  • Late diagnosis in the HAART era: proposed common definitions and associations with mortality [2010]

• British HIV Association
  • Monitoring of older HIV-1-positive adults by HIV clinics in the United Kingdom: a national quality improvement initiative [2020]
  • BHIVA guidelines for the routine investigation and monitoring of adult HIV-1-positive individuals 2016 (2019 interim update) [2019]

United States

• AIDS
  • Impact of increased uptake of long-acting injectable antiretroviral therapy on HIV incidence and viral suppression in the United States under 2021 FDA guidelines [2025]

• Centers for Disease Control and Prevention
  • Antiretroviral Therapy and Viral Suppression Among Active Duty Service Members with Incident HIV Infection — United States, January 2012–June 2018 [2020]
  • Racial and Ethnic Disparities in Sustained Viral Suppression and Transmission Risk Potential Among Persons Receiving HIV Care — United States, 2014 [2018]

• Clinicalinfo
  • Laboratory Testing for Initial Assessment and Monitoring of People With HIV Receiving Antiretroviral Therapy

• Journal of the International Association of Providers of AIDS Care
  • Clinician Perspectives on Delaying Initiation of Antiretroviral Therapy for Clinically Eligible HIV-Infected Patients [2015]

• New York State Department of Health AIDS Institute
  • Virologic and Immunologic Monitoring in HIV Care

• Open Forum Infectious Diseases
  • Toward Ending the HIV Epidemic: Temporal Trends and Disparities in Early ART Initiation and Early Viral Suppression Among People Newly Entering HIV Care in the United States, 2012-2018 [2022]

• Women's Health
  • Factors associated with viral suppression among cisgender women living with human immunodeficiency virus in the United States: An integrative review [2022]

Vietnam

• PLoS ONE
  • Assessment of WHO criteria for identifying ART treatment failure in Vietnam from 2007 to 2011 [2017]

WHO

• World Health Organization
  • The role of HIV viral suppression in improving individual health and reducing transmission [2023]
  • Module for assessing and strengthening the quality of viral load testing data within HIV programmes and patient monitoring systems: implementation tool, 2nd ed [2023]
  • Module for assessing and strengthening the quality of viral load testing data within HIV programmes and patient monitoring systems [2020]
  • Considerations for developing a monitoring and evaluation framework for viral load testing [2019]
  • HIV treatment and care: what's new in treatment monitoring: viral load and CD4 testing: information note [2017]
  • Laboratory Monitoring - Antiretroviral Therapy for HIV Infection in Adults and Adolescents [2010]

WHO Eastern Mediterranean Region

• WHO Eastern Mediterranean Region
  • HIV test–treat–retain cascade analysis: Guide and tools 2017 [2017]

WHO South-East Asia Region

• WHO South-East Asia Region
  • Guidelines for HIV diagnosis and monitoring of antiretroviral therapy, Rev.2 [2009]

Zambia

• PLoS Medicine
  • Estimating the real-world effects of expanding antiretroviral treatment eligibility: Evidence from a regression discontinuity analysis in Zambia [2018]

Zimbabwe

• Frontiers in Public Health
  • HIV Disease Progression Among Antiretroviral Therapy Patients in Zimbabwe: A Multistate Markov Model [2019]

• Public Health Action
  • Critical considerations for adopting the HIV ‘treat all’ approach in Zimbabwe: is the nation poised? [2016]

{Related topics}

• Topic
  • Antiretroviral therapy