Point-of-care nucleic acid testing - a step forward in controlling the HIV epidemic: A review.

Abstract

Introduction: The HIV/AIDS epidemic, with 85.6 million infections and 40.4 million AIDS-related deaths globally, remains a critical public health challenge. Current diagnostic methods, primarily fourth-generation immunoassays, have limitations due to their long window periods, and most viral load assays require centralized testing protocols that result in delays, especially in remote regions.

Nucleic acid testing: Point-of-care (POC) nucleic acid amplification testing (NAAT) presents a transformative approach by reducing the window period for detection to one week and significantly shortening turnaround times for viral load monitoring.

Discussion: This review highlights the clinical utility of POC NAAT for acute HIV infection diagnosis, its role in timely combination antiretroviral therapy adjustments, and its potential to reduce the basic reproduction number (R₀), a critical threshold for suppressing the epidemic.

Conclusion: By improving early detection and facilitating faster clinical decisions, POC NAAT enhances the effectiveness of HIV prevention and treatment programmes, particularly in high-risk and remote communities, and supports the global effort to achieve the ambitious UNAIDS 95-95-95 targets.