Despite tremendous improvements in viral load (VL) monitoring and early infant diagnosis (EID) in many countries, low VL and EID testing rates and low VL suppression rates persist in specific regions and among certain subpopulations. The VL/EID cascade includes patient and provider demand creation, sample collection and transportation, laboratory testing, results transmission back to the clinic, and patient management. Gaps in communication and coordination between clinical and laboratory counterparts can lead to suboptimal outcomes, such as delay or inability to collect and transport samples to the laboratory for testing and failure of test results to reach providers and patients in an efficient, timely, and effective manner. To bridge these gaps and optimize the impact of VL/EID scale-up, we reviewed the components of the cascade and their interrelationships to identify barriers and facilitators. As part of this process, people living with HIV must be engaged in creating demand for VL/EID testing. In addition, there should be strong communication and collaboration between the clinical and laboratory teams throughout the cascade, along with joint performance review, site visits, and continuous quality improvement activities. Strengthening the clinical/laboratory interface requires innovative solutions and implementation of best practices, including the use of point-of-care diagnostics, simplified data systems, and an efficient supply chain system to minimize interface gaps.

中文翻译：

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临床/实验室界面干预可改善病毒载量的影响并扩大婴儿诊断测试的规模。

尽管在许多国家中，病毒载量（VL）监测和早期婴儿诊断（EID）有了显着改善，但在特定区域和某些亚人群中，低VL和EID检测率和低VL抑制率仍然存在。VL / EID级联包括患者和提供者需求创建，样品收集和运输，实验室测试，将结果传输回诊所以及患者管理。临床和实验室对口方之间沟通与协调上的差距可能导致不理想的结果，例如延误或无法收集和运输样品到实验室进行测试，以及测试结果无法有效，及时，有效地到达提供者和患者。为了弥合这些差距并优化VL / EID扩大规模的影响，我们回顾了级联的组成部分及其相互关系，以确定障碍和促进者。作为此过程的一部分，艾滋病毒携带者必须参与对VL / EID检测的需求。此外，在整个级联过程中，临床团队和实验室团队之间应进行强有力的沟通和协作，并进行联合绩效评估，现场考察和持续的质量改进活动。加强临床/实验室界面需要创新的解决方案和最佳实践的实施，包括使用即时诊断，简化的数据系统和有效的供应链系统，以最大程度地减少界面差距。此外，在整个级联过程中，临床团队和实验室团队之间应进行强有力的沟通和协作，并进行联合绩效评估，现场考察和持续的质量改进活动。加强临床/实验室界面需要创新的解决方案和最佳实践的实施，包括使用即时诊断，简化的数据系统和有效的供应链系统，以最大程度地减少界面差距。此外，在整个级联过程中，临床团队和实验室团队之间应进行强有力的沟通和协作，并进行联合绩效评估，现场考察和持续的质量改进活动。加强临床/实验室界面需要创新的解决方案和最佳实践的实施，包括使用即时诊断，简化的数据系统以及有效的供应链系统，以最大程度地减少界面差距。