title: Point-of-Care Viral Load Testing for Sub-Saharan Africa: Informing a Target Product Profile.
abstract: Point-of-care viral load tests are being developed to monitor patients on antiretroviral therapy (ART) in sub-Saharan Africa. Test design involves trade-offs between test attributes, including accuracy, complexity, robustness, and cost. We used a model of the human immunodeficiency virus epidemic and ART program in Zimbabwe and found that the attributes of a viral load testing approach that are most influential for cost effectiveness are avoidance of a high proportion of failed tests or results not received, use of an approach that best facilitates retention on ART, and the ability to facilitate greater use of differentiated care, including through expanding coverage of testing availability.
authors.affiliation: Department of Infection and Population Health , University College London (UCL) , United Kingdom.
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Phillips
authors.affiliation: Department of Infection and Population Health , University College London (UCL) , United Kingdom.
authors.forename: Valentina
authors.initials: V
authors.lastname: Cambiano
authors.affiliation: Department of Infection and Population Health , University College London (UCL) , United Kingdom.
authors.forename: Fumiyo
authors.initials: F
authors.lastname: Nakagawa
authors.affiliation: MRC Clinical Trials Unit at UCL , Institute of Clinical Trials and Methodology , London , United Kingdom.
authors.forename: Deborah
authors.initials: D
authors.lastname: Ford
authors.affiliation: Ministry of Health and Child Care , Causeway, Harare , Zimbabwe.
authors.forename: Tsitsi
authors.initials: T
authors.lastname: Apollo
authors.affiliation: Ministry of Health and Child Care , Causeway, Harare , Zimbabwe.
authors.forename: Joseph
authors.initials: J
authors.lastname: Murungu
authors.affiliation: Bill & Melinda Gates Foundation , Seattle, Washington.
authors.forename: Christine
authors.initials: C
authors.lastname: Rousseau
authors.affiliation: Bill & Melinda Gates Foundation , Seattle, Washington.
authors.forename: Geoff
authors.initials: G
authors.lastname: Garnett
authors.affiliation: Bill & Melinda Gates Foundation , Seattle, Washington.
authors.forename: Peter
authors.initials: P
authors.lastname: Ehrenkranz
authors.affiliation: Department of Infection and Population Health , University College London (UCL) , United Kingdom.
authors.forename: Loveleen
authors.initials: L
authors.lastname: Bansi-Matharu
authors.affiliation: Clinton Health Access Initiative , Boston, Massachusetts.
authors.forename: Lara
authors.initials: L
authors.lastname: Vojnov
authors.affiliation: Clinton Health Access Initiative , Boston, Massachusetts.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Katz
authors.affiliation: Clinical Research Department , London School of Hygiene and Tropical Medicine , United Kingdom.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Peeling
authors.affiliation: Centre for Health Economics , University of York , Heslington , United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Revill
keywords: antiretroviral therapy; cost-effectiveness; model; point-of-care; viral load