Peruvian experience on the human immunodeficiency virus diagnostic flowchart

Mr Editor: The Joint United Nations Program on HIV/AIDS (UNAIDS) proposed as a goal that the countries reach 95-95-95 by the year 2030, in other words, that 95% of people living with HIV (PLH) are diagnosed and of these that 95% receive antiretroviral treatment (ART) and at least 95% have undetectable viral load or viral suppression.

The Joint United Nations Program on HIV/AIDS (UNAIDS) proposed as a goal that the countries reach 95-95-95 by the year 2030, in other words, that 95% of people living with HIV (PLH) are diagnosed and of these that 95% (1) receive antiretroviral treatment (ART) and at least 95% have undetectable viral load or viral suppression .
In order to close the rst gap, that is, the rst 95, the MINSA began expanding the coverage of HIV diagnosis a few years ago through the use of rapid tests at all levels of care in the health system, as This is why the World Health Organization has recommended modi cations in the diagnostic owcharts, which shorten the time to (3) de ne a person with HIV infection and that he or she can receive early treatment .
An observational descriptive study was carried out during November 2021 at the National Reference Laboratory for Sexually Transmitted Viruses HIV/AIDS of the National Institute of Health (INS); Secondary data of diagnostic results were analyzed without access to patient identi cation, so it did not require the approval of an ethics committee since it was a necessity in national HIV surveillance to have information to provide technical guidance to the healthcare workers.
In the novelty of these owcharts, the consideration of two reactive results to two screening tests as a case of (4,5) HIV infection is highlighted ; however, there is currently no relevant information on the experience of its applicability in the Peruvian population. For these reasons, the following objective was set: Identify the results of con rmatory HIV serological tests in Peruvian samples with two reactive results to two different screening tests.
The HIV diagnosis owcharts for people over 18 months of age, which are contained in the three technical health standards currently in force, de ne a case of HIV infection as those people who have two reactive results to two screening tests from different manufacturers. or of a different principle, considering screening tests to be the Rapid Test (RT), Enzyme-Linked Immunosorbent Assay (ELISA), Chemiluminescence (CLIA) and Electrochemiluminescence (ECLIA). It is important to highlight the following cases as cases: a) two reactive results of two third-generation RPs from different manufacturers b) two reactive results of two RPs, one thirdgeneration and one fourth-generation c) One third-or fourth-generation RP generation and an ELISA or equivalent with reactive results d) A third or fourth generation RP with a reactive result and a positive (4,6) con rmatory test: viral load, indirect immuno uorescence (IIF) or immunoblot .

Mr. Editor
autoimmune diseases and in multiparous women .
The high concordance demonstrated in the studied samples that were positive to the con rmatory serological tests (98.6%) allows us to show that the HIV diagnosis owchart in the Peruvian population presents a high reliability in its application, consequently the results obtained allow us to indicate that samples with two reactive results to screening tests should not be referred for serological con rmation (IIF and Immunoblot) and should be sent directly for viral load analysis; in this way, patients would access timely ART.