Viral load tests for people living with the Human Immunodeficiency Virus (HIV) are being carried out again in Bolívar state after more than four years without being available due to lack of reagents and other factors.
Boys and girls, pregnant women and people who require surgery, chemotherapy treatment or hemodialysis are the ones who have priority access to these tests, since the number of reagents is limited and there is only one specialized team in the state to process them.
The tests are collected at the Las Manoas outpatient clinic in Ciudad Guayana, Hospital del Tórax in Ciudad Bolívar and Hospital Gervasio Vera Custodio in Upata, and then analyzed at the High Technology Public Health Laboratory Dr. Armando Ortegalocated next to the Uyapar Hospital, in Puerto Ordaz and inaugurated in March of this year.
In this laboratory is the only geneexpert that there is in the state of Bolívar. This 16-cartridge kit processes tests for HIV, tuberculosis, and COVID-19.
“As we are starting, at the moment we process an average of 15 tests a day, approximately 100 a week,” reported Ana Karina Rodríguez, a bioanalyst who works at the facility.
The results are available in 15 days, according to Andrea Torres*, a nurse who works in the HIV service of the Las Manoas module.
“These are very expensive reagents, that is why they are not available to the entire population, but to a specific group that deserves it according to the doctor’s criteria. They (staff from the Dr. Armando Ortega laboratory) have not launched conferences for the general public. When the laboratory is fully installed, they will receive the cartridges to process more samples”, he informed.
In general, these tests are centralized in a few specialized private laboratories, mostly located in Caracas. Its cost in the private sector exceeds 100 dollars.
Since access to testing is limited in the public sector, patients who cannot afford it are treated blindly, or moved to neighboring countries for medical monitoring.
Access to viral load tests is vital for all patients
A person with HIV requires uninterrupted access to personalized antiretroviral (ARV) treatment for life and timely access to viral load and CD4 control tests, at least twice a year.
The viral load test is one of the most important for the control of people living with HIV because it measures how many copies of the virus are in the blood and guides specialists on how the person is responding to antiretroviral treatment.
|As we are starting, at the moment we process an average of 15 tests per day, approximately 100 per week”, Anna Rodriguez
The viral load test, together with uninterrupted treatment, are essential in prenatal care to reduce the chances of transmitting the virus from the mother with HIV to the baby.
An undetectable viral load – which is only achieved with uninterrupted access to treatment – means that the person cannot transmit the virus. And this is an important epidemiological variable.
Limited diagnostic and control capacity
In 2016, the Ministry of Health stopped bringing the medicines and reagents necessary for these tests to the country. In the framework of Master Plan for Strengthening the Response to Tuberculosis, Malaria and HIV promoted by the Pan American Health Organization (PAHO), the treatment required by patients entered the country again (although in insufficient quantity). And, starting last year, some reagents to process viral load tests.
in 2021 a special day of viral load tests was activated in Ciudad Guayana exclusively for patients at the Las Manoas outpatient clinic, and the Ministry of Health proceeded to collect samples from the patients to analyze them in Caracas. Due to problems in the transfer, and insufficient reagents, the results of those tests never came.
The support of multilateral organizations will always be insufficient as long as the State -as the main guarantor of health- does not assume its responsibility to buy supplies for diagnosis, control and treatment of HIV.
Diagnostic and medical care capacity in the public health sector remains limited. During the second half of 2021, the NGO Acción Solidaria denounced in its report Living with HIV in Venezuela that not only have there been no reagents for viral load and lymphocyte count tests for at least five years, but there are also not enough for serological tests for hepatitis, cytomegalovirus, histoplasmosis, tuberculosis, profile 20, and other tests that are part of the routine screening of people with HIV, often vulnerable to opportunistic diseases.