Toolkit
HIV Treatment and Care
The aim of the operational framework is to ensure 1) accurate collection, handling, shipment and storage of specimens collected in countries implementing HIV drug resistance surveillance; and 2) the availability of quality-assured HIV genotyping laboratory services producing comparable and reliable ...results at the national, regional and global levels.
This publication updates the WHO HIVResNet HIV drug resistance laboratory operational framework published in 2017 and reflects technical and strategic developments over the past three years.
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WHO recommends that pre-exposure prophylaxis (PrEP) be offered as an additional prevention choice for HIV-negative individuals at substantial risk of HIV infection as part of combination prevention approaches.
HIV drug resistance has been rarely reported among PrEP users who tested HIV positive i...n randomized controlled trials or open-label studies. However, PrEP-selected HIV drug resistance could potentially negatively impact the effectiveness of treatment options among PrEP users who acquire HIV, since there is a potential for overlapping resistance profiles between antiretroviral drugs used for both PrEP and first-line antiretroviral therapy.
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WHO recommends replacing western blotting and line immunoassays with simpler tests in HIV testing services. These simpler tests include rapid diagnostic tests (RDTs) that can be used at the point-of-care, and enzyme immunoassays (EIAs).
These tests get results to the client faster, produce accura...te results more often, cost less, can be performed by various cadres of health providers, and can thus facilitate greater access and uptake of HIV testing services among those who need it most.
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Policy Brief.
WHO recommends that pregnant women receive testing for HIV, syphilis and hepatitis B (HBSAg) at least once during pregnancy, preferably in the first trimester.
Dual HIV/syphilis rapid diagnostic tests (RDTs) can be used as the first test for pregnant women as part of antenatal care (...ANC).
These simple tests can be used at the point-of-care and are cost-saving compared to standard testing in ANC. They enable more women to be diagnosed with HIV and syphilis so that they can access treatment and prevent transmission to their children.
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The Guide to operationalize HIV viral load testing HIV presents 60 lessons learnt from the project in a systemic approach including: viral load strategy, laboratories, procurement and supply management, patient care and economy.
L’OMS recommande aux femmes enceintes de faire un test de dépistage du VIH, de la syphilis et de l’hépatite B (HBsAg) au moins une fois pendant la grossesse, de préférence au cours du premier trimestre. Le double test de diagnostic rapide (TDR) VIH/syphilis peut être utilisé comme premier ...test pour les femmes enceintes dans le cadre des soins prénataux. Ces tests simples peuvent être utilisés sur le lieu de soins et sont économiques par rapport aux tests standards de soins prénataux.
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Intensificar o reforço das abordagens de monitorização do tratamento através dos testes da carga viral, assim como o diagnóstico pediátrico precoce, será fundamental para garantir cuidados e tratamentos de boa qualidade e o êxito dos programas. Considerar uma boa rede de diagnósticos, tipos... de amostras, intervenções e estratégias em cada um dos países e em todas as partes interessadas nacionais, regionais e parceiros contribuirá para apoiar este esforço, melhorar a colaboração e maximizar o investimento nos diagnósticos para um impacto clínico visível.
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The updated guidelines present a standard minimum dataset, priority indicators and recommendations to strengthen data use across HIV prevention, testing and treatment, and linkages to services for sexually transmitted infections, viral hepatitis, tuberculosis and cervical cancer. The guidelines also... cover the use of routinely collected data for HIV surveillance (including measurement of HIV prevalence and incidence) and emphasize the use of data from different sources to gain a better picture of epidemiologic trends. The whole collection you can download from here https://www.who.int/publications/i/item/9789240055315
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The updated guidelines present a standard minimum dataset, priority indicators and recommendations to strengthen data use across HIV prevention, testing and treatment, and linkages to services for sexually transmitted infections, viral hepatitis, tuberculosis and cervical cancer. The guidelines also... cover the use of routinely collected data for HIV surveillance (including measurement of HIV prevalence and incidence) and emphasize the use of data from different sources to gain a better picture of epidemiologic trends.
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To meet the need for laboratory diagnosis to be integrated in community care, the new 2022 Update describes point-of-care tests that can be performed both in district laboratories and peripheral healthcare facilities by non-specialist staff. Also included are recently developed self-tests.
WHO’s sentinel surveys of acquired HIV resistance to dolutegravir among people receiving dolutegravir-containing antiretroviral therapy is intended for easy and frequent implementation. Results from sentinel surveys provide insight into the prevalence and year-over-year trends of dolutegravir resi...stance in adults, children and adolescents receiving dolutegravir-based ART.
This sentinel method is implemented complementary to WHO-recommended methods for estimating nationally representative levels of acquired HIV drug resistance.
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Recency assays use one or more biomarkers to identify whether HIV infection in a person is recent (usually within a year or less) or longstanding. Recency assays have been used to estimate incidence in representative cross-sectional surveys and in epidemiological studies to better understand the pat...terns and distributions of new and longstanding HIV infections.
This technical guidance outlines best practices regarding the appropriate use of HIV recency assays for surveillance purposes and updates 2011 technical guidance from the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) on the use of HIV recency assays.
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Lateral-flow rapid diagnostic tests (RDTs) continue to play a vital role in global health in the management and diagnosis of infectious diseases, including malaria, HIV and COVID-19. Visually interpreted RDTs, more than any other class of diagnostics, fulfil WHO’s ASSURED criteria,1 enabling their... use at the lowest levels of health care and in self-testing.2 Their utility is, however, compromised every time a test is incorrectly performed or interpreted or its result is not available in a timely manner for clinical decisionmaking and surveillance.
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Avec l’essor des traitements antirétroviraux (TAR) à base de dolutégravir (DTG) pour soigner les personnes vivant avec
le VIH dans le monde, il est important d’estimer la vitesse à laquelle la résistance acquise au DTG apparaît dans les
populations sous TAR. Bien que la résistance au DT...G ne soit pas apparue dans les populations naïves aux TAR incapables
de supprimer la charge virale dans les essais cliniques, certains éléments portent à croire que la résistance au
DTG peut émerger chez les personnes suivant des schémas thérapeutiques incluant le DTG. L’OMS recommande aux
pays qui étendent les TAR incluant le DTG d’accompagner ce déploiement d’une surveillance en routine de la pharmacorésistance
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A medida que el tratamiento antirretrovírico con dolutegravir se extiende a más personas que viven con el VIH en el
mundo, adquiere más importancia estimar la frecuencia con que surge la farmacorresistencia adquirida a este
antirretrovírico en las poblaciones tratadas con esquemas que lo conti...enen. Si bien no se ha detectado resistencia
al dolutegravir en los ensayos clínicos con poblaciones no tratadas antes con antirretrovíricos en las que se ha
detectado una viremia persistente pese al tratamiento, los datos indican que puede surgir en quienes toman esquemas
con dolutegravir. La OMS recomienda a los países que estén ampliando el tratamiento con dolutegravir que acompañen
su despliegue con la vigilancia sistemática de la farmacorresistencia.
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This updated manual provides a basic understanding of the principles of laboratory and point-of-care (POC) testing in the context of screening and diagnostic approaches, as well as antimicrobial susceptibility testing, as components of sexually transmitted infections (STIs) control. As with previous... editions, this manual covers each disease in a separate chapter which provides detailed information on specimen collection, transport and laboratory testing. Two useful annexes covering media, reagents, diagnostic tests and stains (recipes) and laboratory supplies are included at the end of the manual.
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These guidelines outline a public health approach to strengthening and expanding HIV testing services (HTS). They present and discuss key updates to WHO guidelines on HTS, with a focus on new evidence, new recommendations, good practices and operational considerations that respond to the changing ne...eds of national programmes.
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