{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T08:13:54Z","timestamp":1777364034522,"version":"3.51.4"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T00:00:00Z","timestamp":1676332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","award":["ISR-17-10142"],"award-info":[{"award-number":["ISR-17-10142"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In Zimbabwe, children, adolescents and young adults living with HIV (CALWH) who are on public health antiretroviral therapy (ART) have inadequate viral load (VL) suppression. We assessed whether a clinic-based VL monitoring could decrease 12-month virologic failure rates among these CALWH.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The study was registered on ClinicalTrials.gov: NCT03986099. CALWH in care at Chidamoyo Christian Hospital (CCH) and 8 rural outreach sites (ROS) on long-term community-based ART were randomized (1:1) to 6 monthly VL monitoring by COBAS\u00aeAmpliprep\u00ae\/Taqman48\u00ae HIV-1 at the provincial referral laboratory (PRL) as per standard of care (SOC) or by the clinic-based SAMBA II assay, Diagnostics for the Real World, at CCH. VL suppression, turn-around-time (TAT) for VL results, drug switching and drug resistance in second-line failure were assessed at 12 months.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 390 CALWH enrolled 347 (89%) completed 12 months follow-up. Median (IQR) age and ART duration were 14.1 (9.7\u201318.2) and 6.4 (3.7\u20137.9) years, respectively. Over half (57%) of the participants were female. At enrolment, 78 (20%) had VL \u22651,000 copies\/ml and VL suppression of 80% was unchanged after 12 months, with no significant difference between the SOC (81%) and the clinic-based (80%) arms (p = 0.528). Median (IQR) months to confirmatory VL result at CCH vs PRL was 4.0 (2.1\u20134.4) vs 4.5 (3.5\u20136.3) respectively; p = 0.027 at 12 months. Drug switching was documented among 26\/347 (7%) participants with no difference between the median (IQR) time to switch in SOC vs clinic-based arms (5.1 (3.9\u201310.0) months vs 4.4 (2.5\u20138.4) respectively; p = 0.569). Out of 24 confirmed second-line failures, only 4\/19 (21%) had protease inhibitor resistance.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>In rural Zimbabwe, the clinic-based SAMBA II assay was able to provide confirmatory VL results faster than the SOC VL assay at the PRL. However, this rapid TAT did not allow for a more efficient drug switch among these CALWH.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0281279","type":"journal-article","created":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T18:28:52Z","timestamp":1676399332000},"page":"e0281279","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinic-based SAMBA-II vs centralized laboratory viral load assays among HIV-1 infected children, adolescents and young adults in rural Zimbabwe: A randomized controlled trial"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3531-7780","authenticated-orcid":true,"given":"Vinie","family":"Kouamou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhoderick","family":"Machekano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tichaona","family":"Mapangisana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Maposhere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reggie","family":"Mutetwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justen","family":"Manasa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tinei","family":"Shamu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathy","family":"McCarty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shungu","family":"Munyati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junior","family":"Mutsvangwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mampedi","family":"Bogoshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"Israelski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Katzenstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,2,14]]},"reference":[{"key":"pone.0281279.ref001","volume-title":"Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach","author":"World Health Organization","year":"2016"},{"key":"pone.0281279.ref002","first-page":"5","article-title":"Modeling the HIV epidemic: why the 95-95-95Target and ART effectiveness parameters matter","author":"R Granich","year":"2018","journal-title":"Int J Virol AIDS"},{"issue":"3","key":"pone.0281279.ref003","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1093\/inthealth\/iht016","article-title":"Community-based antiretroviral therapy programs can overcome barriers to retention of patients and decongest health services in sub-Saharan Africa: a systematic review","volume":"5","author":"T Decroo","year":"2013","journal-title":"Int Health"},{"issue":"1","key":"pone.0281279.ref004","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1097\/COH.0000000000000509","article-title":"Differentiated service delivery: navigating the path to scale","volume":"14","author":"P Ehrenkranz","year":"2019","journal-title":"Curr Opin HIV AIDS"},{"key":"pone.0281279.ref005","article-title":"2020 Global AIDS Update \u2060\u2014Seizing the moment \u2060\u2014Tackling entrenched inequalities to end epidemics. 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