Improving access to virological follow-up for adults and children infected by HIV: a national workshop organized at the Christophe Mérieux Centre of Infectiology in Laos

July 2, 2012

A national workshop on the ’Improvement of the access to virological follow-up for adults and children infected by HIV’ took place in Loas, from May 23-25, 2012. The workshop was organized by the National AIDS Programme in Laos (CHAS), the Christophe Mérieux Centre of Infectiology in Laos (CICML) and ESTHER.

The meeting was hosted by the CICML and received an important funding from the Global Fund and from Fondation Mérieux. The training has been carried out by experts of the National Programme and several institutions in the region: Fondation Mérieux, Institut Pasteur, ESTHER (Chiang Mai Hospital (Thailand) and HAIVN (Vietnam).

This meeting gathered together 50 doctors coming from various antiretroviral treatment sites in Laos to improve their knowledge, and exchange information about clinical cases.

The workshop began with a presentation from different partners and public health actors on the situation of HIV/AIDS epidemic disease in Laos, followed by a summary of the activities associated with the viral load and the financial means devolved. The workshop consisted of several sessions: resistance to antiretrovirals (ARV), early diagnosis for children born to HIV infected mothers and the prevention of mother to child transmission, with a presentation of the situations in Laos, Cambodia, Vietnam, Thailand and France. The meeting ended with practical clinical case studies, giving the opportunity to share experiences.

This workshop is the 5th meeting organized by the CHAS and its partners on HIV virological monitoring.

The first workshop on HIV/AIDS, organized in November 2009, aimed to inform the health authorities, partners, clinicians and laboratories, of the introduction of HIV-1 viral load testing at the Christophe Mérieux Centre of Infectiology of Laos. The second workshop, organized in May 2010, aimed at evaluating the use of viral load and discussing the viral failures under ARV. In November 2010, the third workshop, announcing the setting up of ARV resistance testing ,addressed the issue of the patients’ adherence to treatment and the interpretation of virologic results .

The main topic of the fourth workshop was related to early infant diagnosis in children under 18 months. This workshop helped set up early infant diagnosis on dry blood spot (DBS) in Laos.

These workshops, thanks to an exceptional collaboration between the National AIDS Programme in Laos and the different partners, helped initiate and develope HIV virology in Laos with the setting up of the quantitative viral load, resistance testing and early infant diagnosis.

Since June 2009, 3,443 viral load tests have been carried out on 2,046 patients, representing 86% of the patients under ARV in the country. Among them, 59 had a resistance test. 61 children under 18 months did the early diagnosis test; 8 were infected with HIV.

ESTHER significantly contributed to the setting up of viral load testing by funding the first tests in two regions in Laos: Mahosot National Hospital in Vientiane and Luang Prabang Regional Hospital. The funding of viral load testing will be completely supported by the Global Fund from 2012.

The National Programme, which would like to appropriate these workshops, received funding from the Global Fund for their continuation. A 6th workshop is planned in November 2012.

Dr Gérald Viretto, MD, MPH,Projects Manager Asia, GIP ESTHER

Dr Phimpha Paboriboune, MD, MPH, Scientific Director, Centre of InfectiologyChristophe Mérieux Laos