ABSTRACT
Globally, HIV-1 has caused 25 million deaths and another 33 million infections, mostly occurring in sub-Saharan Africa.1 To curb the HIV/AIDS epidemic and improve the quality of life of AIDS patients, antiretroviral treatment (ART) has been rapidly expanded in developing countries. Despite these efforts, there were only 4 million AIDS patients on treatment by the end of 2008, accounting for only 42% of AIDS patients who urgently need ART.3 The main reason for this is the lack of cost-effective and easy-to-use ART monitoring tools in resource-limited settings. In industrialized countries, ART is closely monitored for immunological recovery (CD4+ cell count, every 3-4 months), virological failure (two consecutive viral loads > 50 copies/ml), and drug resistance.4,5 However, these assays require expensive instruments, air conditioning, and skillful operators. In contrast, ART in developing countries is often monitored by the World Health Organization (WHO) clinical staging and CD4+ T lymphocyte counts.6 In rural areas, blood samples are often collected at local clinics and sent to centralized laboratories.
