Cohort profile: the Viral load Cohort North-East Lesotho (VICONEL) from 2016 to 2023 – cohort description, test volumes, predictors of viraemia and the road ahead

Purpose The prospective Viral load Cohort North-East Lesotho (VICONEL) aims to support clinical management and generate scientific evidence to inform HIV care. Specifically, VICONEL allows for the monitoring of HIV treatment outcomes and health system performance, encompasses a biobank for further r...

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Main Authors: Tracy Glass, Frédérique Chammartin, Jochen Ehmer, Thomas Klimkait, Alain Amstutz, Josephine Muhairwe, Irene Ayakaka, Blaise Lukau, Jennifer Anne Brown, Lipontso Motaboli, Malebanye Lerotholi, Maurus Kohler, Kathrin Haenggi, Moliehi Mokete, Makobefo Gladys Chakela, Mpho Kao, Mathebe Kopo, Moleboheng Mokebe, Lorena Urda, Bienvenu Lengo Nsakala, Anna Klicpera, Nadine Tschumi, Niklaus Daniel Labhardt
Format: Article
Language:English
Published: BMJ Publishing Group 2025-02-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/2/e085404.full
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author Tracy Glass
Frédérique Chammartin
Jochen Ehmer
Thomas Klimkait
Alain Amstutz
Josephine Muhairwe
Irene Ayakaka
Blaise Lukau
Jennifer Anne Brown
Lipontso Motaboli
Malebanye Lerotholi
Maurus Kohler
Kathrin Haenggi
Moliehi Mokete
Makobefo Gladys Chakela
Mpho Kao
Mathebe Kopo
Moleboheng Mokebe
Lorena Urda
Bienvenu Lengo Nsakala
Anna Klicpera
Nadine Tschumi
Niklaus Daniel Labhardt
author_facet Tracy Glass
Frédérique Chammartin
Jochen Ehmer
Thomas Klimkait
Alain Amstutz
Josephine Muhairwe
Irene Ayakaka
Blaise Lukau
Jennifer Anne Brown
Lipontso Motaboli
Malebanye Lerotholi
Maurus Kohler
Kathrin Haenggi
Moliehi Mokete
Makobefo Gladys Chakela
Mpho Kao
Mathebe Kopo
Moleboheng Mokebe
Lorena Urda
Bienvenu Lengo Nsakala
Anna Klicpera
Nadine Tschumi
Niklaus Daniel Labhardt
author_sort Tracy Glass
collection DOAJ
description Purpose The prospective Viral load Cohort North-East Lesotho (VICONEL) aims to support clinical management and generate scientific evidence to inform HIV care. Specifically, VICONEL allows for the monitoring of HIV treatment outcomes and health system performance, encompasses a biobank for further research with routinely collected blood plasma samples of consenting participants and provides a valuable framework for nested observational and interventional studies.Participants VICONEL captures routine viral load test results alongside associated demographic and treatment information among people in care for HIV in Lesotho, southern Africa. As of December 2023, it encompasses all viral load testing from 24 healthcare facilities in two districts of Lesotho.Findings to date From January 2016 to December 2023, 137 660 viral load test results were available for 29 380 participants. At the time of the last viral load test, median age was 42 years (IQR: 33–53); 18 511 (63%) were adult women, 10 029 (34%) adult men and 835 (3%) children <15 years (age/sex missing for 5) and median time taking antiretroviral therapy (ART) was 6.4 years (IQR 3.2–9.9). Overall, the proportion of cohort participants with viral suppression to <1000 copies/mL has continually exceeded 90% and has been above 95% since 2020; however, this proportion has consistently been lower among children. Sex, age category/ART regimen core agent (combined variable), time since ART initiation and district were independently associated with viraemia.Future plans VICONEL offers potential for (1) further digitalisation and automation of results sharing at the client, facility and district/national level, (2) integration of additional clinical and diagnostic data, including comorbidities and drug resistance and (3) embedding randomised trials.
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spelling doaj-art-8e9196a47758471c92f7cac1932761032025-02-07T06:45:10ZengBMJ Publishing GroupBMJ Open2044-60552025-02-0115210.1136/bmjopen-2024-085404Cohort profile: the Viral load Cohort North-East Lesotho (VICONEL) from 2016 to 2023 – cohort description, test volumes, predictors of viraemia and the road aheadTracy Glass0Frédérique Chammartin1Jochen Ehmer2Thomas Klimkait3Alain Amstutz4Josephine Muhairwe5Irene Ayakaka6Blaise Lukau7Jennifer Anne Brown8Lipontso Motaboli9Malebanye Lerotholi10Maurus Kohler11Kathrin Haenggi12Moliehi Mokete13Makobefo Gladys Chakela14Mpho Kao15Mathebe Kopo16Moleboheng Mokebe17Lorena Urda18Bienvenu Lengo Nsakala19Anna Klicpera20Nadine Tschumi21Niklaus Daniel Labhardt229 Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland1 Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland7 SolidarMed, Partnerships for Health, Lucerne, Switzerland2 University of Basel, Basel, Switzerland1 Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland3 SolidarMed, Partnerships for Health, Maseru, Lesotho3 SolidarMed, Partnerships for Health, Maseru, Lesotho3 SolidarMed, Partnerships for Health, Maseru, Lesotho1 Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland3 SolidarMed, Partnerships for Health, Maseru, Lesotho4 Ministry of Health of Lesotho, Maseru, Lesotho1 Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland1 Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland3 SolidarMed, Partnerships for Health, Maseru, Lesotho3 SolidarMed, Partnerships for Health, Maseru, Lesotho3 SolidarMed, Partnerships for Health, Maseru, Lesotho3 SolidarMed, Partnerships for Health, Maseru, Lesotho3 SolidarMed, Partnerships for Health, Maseru, Lesotho1 Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland3 SolidarMed, Partnerships for Health, Maseru, Lesotho1 Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland1 Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland1 Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, SwitzerlandPurpose The prospective Viral load Cohort North-East Lesotho (VICONEL) aims to support clinical management and generate scientific evidence to inform HIV care. Specifically, VICONEL allows for the monitoring of HIV treatment outcomes and health system performance, encompasses a biobank for further research with routinely collected blood plasma samples of consenting participants and provides a valuable framework for nested observational and interventional studies.Participants VICONEL captures routine viral load test results alongside associated demographic and treatment information among people in care for HIV in Lesotho, southern Africa. As of December 2023, it encompasses all viral load testing from 24 healthcare facilities in two districts of Lesotho.Findings to date From January 2016 to December 2023, 137 660 viral load test results were available for 29 380 participants. At the time of the last viral load test, median age was 42 years (IQR: 33–53); 18 511 (63%) were adult women, 10 029 (34%) adult men and 835 (3%) children <15 years (age/sex missing for 5) and median time taking antiretroviral therapy (ART) was 6.4 years (IQR 3.2–9.9). Overall, the proportion of cohort participants with viral suppression to <1000 copies/mL has continually exceeded 90% and has been above 95% since 2020; however, this proportion has consistently been lower among children. Sex, age category/ART regimen core agent (combined variable), time since ART initiation and district were independently associated with viraemia.Future plans VICONEL offers potential for (1) further digitalisation and automation of results sharing at the client, facility and district/national level, (2) integration of additional clinical and diagnostic data, including comorbidities and drug resistance and (3) embedding randomised trials.https://bmjopen.bmj.com/content/15/2/e085404.full
spellingShingle Tracy Glass
Frédérique Chammartin
Jochen Ehmer
Thomas Klimkait
Alain Amstutz
Josephine Muhairwe
Irene Ayakaka
Blaise Lukau
Jennifer Anne Brown
Lipontso Motaboli
Malebanye Lerotholi
Maurus Kohler
Kathrin Haenggi
Moliehi Mokete
Makobefo Gladys Chakela
Mpho Kao
Mathebe Kopo
Moleboheng Mokebe
Lorena Urda
Bienvenu Lengo Nsakala
Anna Klicpera
Nadine Tschumi
Niklaus Daniel Labhardt
Cohort profile: the Viral load Cohort North-East Lesotho (VICONEL) from 2016 to 2023 – cohort description, test volumes, predictors of viraemia and the road ahead
BMJ Open
title Cohort profile: the Viral load Cohort North-East Lesotho (VICONEL) from 2016 to 2023 – cohort description, test volumes, predictors of viraemia and the road ahead
title_full Cohort profile: the Viral load Cohort North-East Lesotho (VICONEL) from 2016 to 2023 – cohort description, test volumes, predictors of viraemia and the road ahead
title_fullStr Cohort profile: the Viral load Cohort North-East Lesotho (VICONEL) from 2016 to 2023 – cohort description, test volumes, predictors of viraemia and the road ahead
title_full_unstemmed Cohort profile: the Viral load Cohort North-East Lesotho (VICONEL) from 2016 to 2023 – cohort description, test volumes, predictors of viraemia and the road ahead
title_short Cohort profile: the Viral load Cohort North-East Lesotho (VICONEL) from 2016 to 2023 – cohort description, test volumes, predictors of viraemia and the road ahead
title_sort cohort profile the viral load cohort north east lesotho viconel from 2016 to 2023 cohort description test volumes predictors of viraemia and the road ahead
url https://bmjopen.bmj.com/content/15/2/e085404.full
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