MSF Experience on Use of HIV Viral Load testing in Myanmar Slide
2 MSF HIV/ART program started since 2003 17 TB/HIV clinics Yangon
Region Taninthayi Region Kachin State Shan State Rakhine State
>30,000 patients are on HAART Waing Maw Moe Gaung Slide 3 3 HIV
Prevention focusing on SW, MSM, DU HIV Care and Support including
HTC, PMTCT, OI management, HAART Laboratory services Network of CD4
facility, 1 Cavidi Viral Load system, GeneXpert, Biochemistry, etc.
Slide 4 4 MSF installed one Cavidi VL system in Yangon Mid 2009
Slide 5 Manual Extraction of RT enzyme and amplification Takes 2
days for one lab tech Leave overnight for final reading 5 Slide 6
Final Reading on the next morning Takes 5 Minutes only Results
obtained through a computer software 29 samples per each run 6
Slide 7 7 Very feasible for resource limited settings.. Does not
require sterile environment/molecular laboratory Allows for
decentralised testing Subtype independent technology Affordable
cost However, Technician dependent Capacity per lab tech:
Collection and Transportation of specimen Slide 8 Max. Capacity
using 2 full time lab tech: - 3 runs (87) per week 156 runs (4524)
per year Current patients on MSF Treatment >29,000 patients on
first line Nearly 1000 patients on second line 3 patients on third
line 8 Slide 9 Estimated patients need of ART 125,000 Currently on
ART - >50,000 2 Viral Load facilities MSF Cavidi system and MoH
PCR system MSF Criteria for VL testing 1 st priority Clinically and
immunologically suspected treatment failure Yearly monitoring for
patients on 2 nd line (a rising VL could be targeted with intense
adherence counseling) 9 Slide 10 10 2.5Hr Boat 6Hr Car 2.5 Hr Air
Slide 11 A simple analysis of VL vs CD4 of 3801 patients with
suspected immunological failure receiving 1 st line ART >1yr
shows 20% (755) - confirmed failure and of those failure, 8% (58)
has CD4 >350 66% (2505) has undetectable VL and of those 66%,
33%(828) has CD4
