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Chapter 41 : Molecular Diagnostics for Use in HIV/AIDS Care and Treatment in Resource-Limited Settings
While access to care and treatment for HIV/AIDS in the developed world is good, in resource-limited settings there still is a need to increase basic access to diagnostics for early detection and treatment. The most persistent challenges in the developing world are molecular tests for early infant diagnosis (EID) and viral load testing for monitoring patients on antiretroviral therapy (ART). The majority of molecular testing options available globally are laboratory-based tests performed on sophisticated instruments requiring dedicated laboratory space and trained technicians. With respect to both viral load and EID testing, there are a good number of platforms available, but their cost and complexity are barriers in resource-limited settings. In the interest of improving the accessibility and affordability of high-quality ART, there is a growing demand for simple, affordable, reliable, and quality-assured point-of-care (POC) diagnostics for use in resource-limited settings. Many contend that POC diagnostics can make ART more scalable and will allow ART service delivery to be significantly decentralized to the community level. At the same time, simplifying diagnostic technologies may reduce the cost of diagnosing and monitoring HIV/AIDS patients without diminishing the quality of care.