Why is this important?
For the first time, WHO has stated in very clear language that zero risk of transmitting HIV is attainable through adherence to appropriate HIV treatment. In addition, healthcare staff should reinforce the undetectable equals untransmittable (U=U) message.
Without doubt, this will reassure people living with HIV about treatment and adherence. It will also reduce hesitancy towards promoting U=U. Delivering clear messages about the benefits of treatment has been shown to encourage HIV testing, reduce stigma and improve HIV treatment outcomes.
WHO recommends additional options and sample types of viral load testing technologies. It emphasizes that prequalified tests and sample types, such as dried blood spot, often enable much better access to viral load testing. National programmes should consider these options to ensure that viral load testing is widely available for all people living with HIV.
This is crucial because routine viral load testing is still inaccessible for millions of people living with HIV, particularly in low- and middle-income countries. It is also important to provide CD4 cell count testing at HIV diagnosis and ART initiation for identifying advanced HIV disease.
What are the three categories of viral load levels?
- Undetectable: No measurable virus (not detected by the test or sample type used); zero risk of transmission to sexual partner(s); minimal risk of vertical transmission
- Suppressed (detected but ≤ 1,000 copies/mL): Almost zero or negligible risk of transmission to sexual partner(s)
- Unsuppressed (>1,000 copies/mL): Increased vulnerability of becoming ill and transmitting HIV to sexual partner(s) and/or children
What are the takeaways from the brief?
