{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T23:13:28Z","timestamp":1789514008580,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T00:00:00Z","timestamp":1696550400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Antiretroviral therapy (ART) monitoring using viral load (VL) testing is challenging in high\u2010burden, limited\u2010resources settings. Chemokine IP\u201010 (interferon gamma\u2010induced protein 10) strongly correlates with human immunodeficiency virus (HIV) VL. Its determination could serve to predict virological failure (VF) and to triage patients requiring VL testing. We assessed the field performance of a semi\u2010quantitative IP\u201010 lateral flow assay (LFA) for VF screening in South Africa, and the cost\u2010effectiveness of its implementation in Mozambique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional study was conducted between June and December 2021 in three primary health clinics in the Western Cape. Finger prick capillary blood was collected from adults on ART for \u22651 year for direct application onto the IP\u201010 LFA (index test) and compared with a plasma VL result \u22641 month prior (reference test). We estimated the area under the receiver operating characteristic curves (AUC), sensitivity and specificity, to evaluate IP\u201010 LFA prediction of VF (VL&gt;1000 copies\/ml). A decision tree model was used to investigate the cost\u2010effectiveness of integrating IP\u201010 LFA combined with VL testing into the current Mozambican ART monitoring strategy. Averted disability\u2010adjusted life years (DALYs) and HIV acquisitions, and incremental cost\u2010effectiveness ratios were estimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 209 participants (median age 38 years and 84% female), 18% had VF. Median IP\u201010 LFA values were higher among individuals with VF compared to those without (24.0 vs. 14.6;\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). The IP\u201010 LFA predicted VF with an AUC = 0.76 (95% confidence interval (CI) 0.67\u20130.85), 91.9% sensitivity (95% CI 78.1\u201398.3) and 35.1% specificity (95% CI 28.0\u201342.7). Integrating the IP\u201010 LFA in a setting with 20% VF prevalence and 61% VL testing coverage could save 13.0% of costs and avert 14.9% of DALYs and 55.7% new HIV acquisitions. Furthermore, its introduction was estimated to reduce the total number of routine VL tests required for ART monitoring by up to 68%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The IP\u201010 LFA is an effective VF triage test for routine ART monitoring. Combining a highly sensitive, low\u2010cost IP\u201010 LFA\u2010based screening with targeted VL confirmatory testing could result in significant healthcare quality improvements and cost savings in settings with limited access to VL testing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.26176","type":"journal-article","created":{"date-parts":[[2023,10,8]],"date-time":"2023-10-08T14:30:42Z","timestamp":1696775442000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Field performance and cost\u2010effectiveness of a point\u2010of\u2010care triage test for HIV virological failure in Southern Africa"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9742-2725","authenticated-orcid":false,"given":"Anna","family":"Saura\u2010L\u00e1zaro","sequence":"first","affiliation":[{"name":"Barcelona Institute for Global Health (ISGlobal) Hospital Cl\u00ednic \u2010 Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3211-6078","authenticated-orcid":false,"given":"Peter","family":"Bock","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health Desmond Tutu TB Centre Faculty of Medicine and Health Sciences Stellenbosch University  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika van den","family":"Bogaart","sequence":"additional","affiliation":[{"name":"Mondial Diagnostics  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie","family":"van Vliet","sequence":"additional","affiliation":[{"name":"Mondial Diagnostics  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Gran\u00e9s","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Epidemiology Hospital Cl\u00ednic de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Nel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health Desmond Tutu TB Centre Faculty of Medicine and Health Sciences Stellenbosch University  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikesh","family":"Naidoo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health Desmond Tutu TB Centre Faculty of Medicine and Health Sciences Stellenbosch University  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Scheepers","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health Desmond Tutu TB Centre Faculty of Medicine and Health Sciences Stellenbosch University  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Saunders","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health Desmond Tutu TB Centre Faculty of Medicine and Health Sciences Stellenbosch University  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00faria","family":"Leal","sequence":"additional","affiliation":[{"name":"Barcelona Institute for Global Health (ISGlobal) Hospital Cl\u00ednic \u2010 Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Ramponi","sequence":"additional","affiliation":[{"name":"Barcelona Institute for Global Health (ISGlobal) Hospital Cl\u00ednic \u2010 Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Paulussen","sequence":"additional","affiliation":[{"name":"Mondial Diagnostics  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias Rinke","family":"de Wit","sequence":"additional","affiliation":[{"name":"Amsterdam Institute for Global Health and Development (AIGHD)  Amsterdam The Netherlands"},{"name":"Department of Global Health Amsterdam University Medical Center (UMC), University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Naniche","sequence":"additional","affiliation":[{"name":"Barcelona Institute for Global Health (ISGlobal) Hospital Cl\u00ednic \u2010 Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6725-5687","authenticated-orcid":false,"given":"Elisa","family":"L\u00f3pez\u2010Varela","sequence":"additional","affiliation":[{"name":"Barcelona Institute for Global Health (ISGlobal) Hospital Cl\u00ednic \u2010 Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,6]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Updated recommendations on service delivery for the treatment and care of people living with HIV. [Internet]. 2021 [cited 2021 Oct 8]; Available from:https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK570385\/"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkv143"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30702-8"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(18)30173-5"},{"key":"e_1_2_12_6_1","unstructured":"Global HIV & AIDS statistics \u2014 Fact sheet | UNAIDS [Internet]. [cited 2022 Nov 2]. Available from:https:\/\/www.unaids.org\/en\/resources\/fact\u2010sheet"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-13504-2"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6547a2"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7021a2"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-08218-0"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix600"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiz252"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25476"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2019.v109i3.13456"},{"key":"e_1_2_12_15_1","unstructured":"Western Cape Department of Health.Routine antiretroviral programme report.Cape Town;2021."},{"key":"e_1_2_12_16_1","unstructured":"The Western Cape consolidated guidelines for HIV treatment: prevention of mother\u2010to\u2010child transmission of HIV (PMTCT) children adolescents and adults.2020."},{"key":"e_1_2_12_17_1","unstructured":"Risk assessment: COVID\u201019 | Covid\u201019 response [Internet]. [cited 2022 Nov 8]. Available from:https:\/\/coronavirus.westerncape.gov.za\/risk\u2010assessment\u2010covid\u201019"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/80.1.27"},{"key":"e_1_2_12_19_1","volume-title":"Relat\u00f3rio Anual das Actividades Relacionadas a HIV\u2010SIDA 2021","author":"Minist\u00e9rio de Sa\u00fade de Mo\u00e7ambique","year":"2022"},{"key":"e_1_2_12_20_1","unstructured":"WHO methods and data sources for global burden of disease estimates 2000\u20132019 [Internet].Geneva;2020. [cited 2022 Nov 8]. Available from:http:\/\/www.who.int\/healthinfo\/statistics\/GlobalDALYmethods_2000_2011.pdf?ua=1"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0142908"},{"key":"e_1_2_12_22_1","volume-title":"Cost\u2010effectiveness in health and medicine","author":"Lipscomb J","year":"1996"},{"key":"e_1_2_12_23_1","volume-title":"Cost\u2010effectiveness in health and medicine. 2nd ed","author":"Basu A","year":"2017"},{"key":"e_1_2_12_24_1","first-page":"121","article-title":"CXCL10\/IP\u201010 in infectious diseases pathogenesis and potential therapeutic implications","volume":"22","author":"Liu M","year":"2011","journal-title":"Cytokine Growth Factor Rev"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2021.119019"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001201"},{"issue":"3","key":"e_1_2_12_27_1","first-page":"72","article-title":"Concurrent infections that rise the HIV viral load","volume":"8","author":"Bentwich Z","year":"2003","journal-title":"J HIV Ther"},{"key":"e_1_2_12_28_1","volume-title":"Screening programmes: a short guide. Increase effectiveness, maximize benefits and minimize harm","year":"2020"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0266934"},{"key":"e_1_2_12_30_1","unstructured":"GDP per capita (current US$)\u2014Mozambique | Data [Internet]. [cited 2022 Nov 8]. Available from:https:\/\/data.worldbank.org\/indicator\/NY.GDP.PCAP.CD?locations=MZ"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2016.02.017"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2018-000964"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.3109\/08958378.2014.955932"},{"key":"e_1_2_12_34_1","unstructured":"WHO guide for standardization of economic evaluations of immunization programmes [Internet].Geneva;2019. [cited 2022 Nov 8]. Available from:https:\/\/www.who.int\/immunization\/documents\/who_ivb_19.10\/en\/"},{"key":"e_1_2_12_35_1","article-title":"Achieving undetectable: what questions remain in scaling\u2010up HIV","author":"M\u00e9decins Sans Fronti\u00e8res (MSF)","year":"2015","journal-title":"MSF Issue Brief"},{"key":"e_1_2_12_36_1","unstructured":"M\u00e9decins Sans Fronti\u00e8res (MSF).How low can we go? Pricing for HIV viral load testing in low\u2010 and middle\u2010income countries.2013."},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw001"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100607"},{"issue":"2","key":"e_1_2_12_39_1","first-page":"140","article-title":"Utilizing point\u2010of\u2010care testing to optimize patient care","volume":"32","author":"Nichols JH","year":"2021","journal-title":"EJIFCC"},{"key":"e_1_2_12_40_1","unstructured":"BoekeCE JosephJ AtemC BandaC CoulibalyKD DoiN et\u00a0al.Evaluation of near point\u2010of\u2010care viral load implementation in public health facilities across seven countries in sub\u2010Saharan Africa.2021[cited 2022 Nov 7]; Available from:http:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.25663\/full"},{"key":"e_1_2_12_41_1","unstructured":"WHO list of prequalified in vitro diagnostic products.Geneva:World Health Organization;2020."},{"key":"e_1_2_12_42_1","doi-asserted-by":"crossref","unstructured":"IdKS SharmaM IdJD NaidooJ DlaminiN MoodleyP et\u00a0al.Comparative cost analysis of point\u2010of\u2010care versus laboratory\u2010based testing to initiate and monitor HIV treatment in South Africa.2019[cited 2022 Nov 7]; Available from:https:\/\/doi.org\/10.1371\/journal.pone.0223669","DOI":"10.1371\/journal.pone.0223669"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(17)30211-4"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01594-16"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.20.5.22024"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.26176","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T21:53:11Z","timestamp":1698616391000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.26176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":44,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1002\/jia2.26176"],"URL":"https:\/\/doi.org\/10.1002\/jia2.26176","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2023.09.18.23295705","asserted-by":"object"}]},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10]]},"assertion":[{"value":"2023-01-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e26176"}}