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Successes of Point-of-Care Viral Load Testing

Paul Drain, MD, MPH, explains how point-of-care viral load testing was successful in providing rapid results to patients in a South African-based study.

Segment Description: Paul Drain, MD, MPH, assistant professor of global health and allergy and infectious diseases at the University of Washington Medicine explains how point-of-care viral load testing was successful in providing rapid results to patients in a South African-based study.

Interview transcript (modified slightly for readability):

Contagion®: Can you discuss the staggering difference between the timeline of patients receiving their viral load testing results between the 2 groups?

Paul Drain, MD, MPH: So, we did find differences in getting the results back to patients. First of all, we separated the results being run and tested from actually communicating the results to patients, which was quite important. So, in the laboratory-based testing, 100% of the viral load tests were conducted and completed and they were entered in the electronic medical record a median of 2 days after the blood draw. It wasn’t a very big difference in actually conducting and completing the test and putting the results into the electronic medical record.

Where we really found a difference was in communicating the results to the patient. Putting the results into the electronic medical record does not mean that the patient gets the results or that the clinician is able to do something about the results.

So, when we looked at the time from blood draw to communicating the results to patients, that’s where we say a median delay of 28 days overall. And when we looked at the midpoint of the study — which is what is reported in the abstract – the median was 41 days from the blood draw, which is quite a long time for those patients to wait to get the viral load results.

What that means is if the patient does have a high viral load, it’s 28 or 41 days that they could be transmitting HIV to other people or they could be selecting for HIV drug resistance if it is not already present. Then we did some qualitative work in the study as well and what we found was that patients in the point-of-care testing arm really appreciated getting these results back on the same day.

It meant that they received those results, they could make behavior changes if they needed to, or switch to a second-line therapy if they needed to. They were able to wait at the clinic for the 2-3 hours for the point-of-care viral load tests to run, so they really appreciated having those results on the same day.