All Hands On Deck… Unloading The Hiv Burden

How next-generation technology is transforming detection and care.

Diagnostics|Jul.05, 2023

The thought of discovering that you have a health condition can be anxiety-inducing. However, an early and accurate diagnosis can be life-saving. Health innovations, today, can put you in charge of your health and empower you to lead a healthy life, even with an infection like HIV

Where do we stand in the fight against HIV?

India is home to the third largest number of PLHIV in the world— an estimated 23.5 lac (2.35 million). However, of these, only 1.78 million know of their status. It is estimated that about 7% of total new HIV infections in India are in children. Perinatal transmission is still the most important route of transmission of HIV in children in India. While the country has seen a decline in HIV prevalence over the last couple of decades, a lot still remains to be done. According to Dr. Ishwar Gilada, Consultant in HIV in Infectious Diseases, Unison Medicare and Research Centre Mumbai and President of AIDs Society of India, "Across India, the HIV burden is significant. Yet, only 79.4% of the total estimated people living with HIV nationwide have been diagnosed positive. There remains a clear need to bridge the availability of diagnostic solutions so more people can have access to testing services."

Besides the gap in availability of diagnostic solutions, the myths, social stigma, and lack of awareness around HIV has added to the difficulty of detecting and managing the infection. People are apprehensive to get themselves tested for fear of being stigmatized. Also, a pandemic like COVID-19 that restricts the possibility of doctors’ consultations and impacts testing protocols, can serve as a setback to the gains we’ve made in HIV diagnosis and care.

Efforts to eradicate the infection need to continue on all fronts, be it studying the virus, raising awareness about the infection, eliminating social taboos, or introducing innovations for screening, testing and treatment. India is gearing to meet the new UNAIDS’ fast-track 95-95-95 goals by 2030, adopted by the National AIDS Control Organization, and the UN Sustainable Development Goal of ‘Ending the AIDS Epidemic as a Public Health Threat by 2030.’ One of the goals of India’s National Strategic Plan to end AIDS (2017–2024) is the elimination of mother-to-child transmission (EMTCT) of HIV. By 2020, 95% of pregnant women should have received testing for HIV and syphilis and 95% of estimated HIV-positive pregnant women should have been on antiretroviral treatment (ART) to achieve an MTCT of less than 5%.

Healthcare innovations like rapid tests for HIV and next-generation testing technology will play a key role in achieving these milestones. 

The pivotal role of point-of-care tests

HIV is a sexually transmitted disease spread through contact with infected blood, semen or vaginal fluids, or by sharing needles and syringes. An early HIV detection test not only helps to prevent transmission of the virus, but also allows a person to seek treatment options and live a longer and healthier life. Regular, early testing is a crucial component in arresting the spread of HIV. Point-of-care testing, which is rapid HIV screening performed in clinical settings by professionals, is enabling people living with HIV (PLHIV) to lead a healthy life. The 4th Gen Rapid test for HIV accurately identifies both HIV antibodies and the antigen within 20 minutes. It is capable of detecting 28% of infections missed by current 3rd generation rapid tests. 

Early diagnosis makes it possible for treatment to begin early on, which in turn, has a positive impact on the person’s long term health. With the high sensitivity and specificity 4th gen rapid tests for HIV, identification of HIV antibodies and antigen have accelerated the HIV detection in blood bank screenings, which otherwise would appear even 15-25 days after infection. Use of early HIV detection tests in antenatal care makes timely and appropriate treatment possible, to prevent mother-to-child transmission. These advanced diagnostic tools used for screening offer valuable data that help to further research and empower us stay ahead of the virus. 

Why mixed-method technologies are the way forward

Scientific innovations allow healthcare providers to build a robust testing strategy that can help PLHIV optimally and more inclusively. Mixed-method technologies that combine lab-based centralized testing and point-of-care testing can help guide the way forward. They are especially critical in areas where voluntary testing is low and access to diagnostics is limited.

Through this approach, more people can access viral load testing (VLT)— a process that guides care and monitoring, to assess PLHIV’s response to treatment. PLHIV need to visit their antiretroviral therapy (ART) centre every 3 months as per the latest protocol, with VLT sample collection typically aligning with this visit. New innovations like Dried Blood Spot (DBS) testing can be used in areas where logistics and sample transportation are a challenge. India has made significant progress on the Triple elimination initiative that aims to eliminate mother-to-child transmission of HIV, syphilis and hepatitis B. To achieve the UN’s complete elimination goal, it is critical to focus on counseling and testing, and make the most of each visit of the expectant mother. Currently in India, DBS is restricted to children for mother-to-child transmission cases. However, it can be further utilized across different age groups to ensure routine testing. Vulnerable groups, including the antenatal population and prison inmates can benefit from this mixed-method.

No matter what the health condition, the first step in the journey of care is always a timely and accurate diagnosis. In the case of an infection like HIV, early detection and routine testing is not just important, but absolutely crucial in curbing the impact of the disease, on individuals, as well as on communities at large. 

Disclaimer: The information mentioned in this document is only suggestive /for patient ducation and shall not be considered as a substitute for doctor’s advice or recommendations from Abbott. Please consult your doctor for more information.