In July 2016, Faith Alive Nigeria, in collaboration with Faith Alive USA, laid the groundwork to start a Center of Excellence laboratory with the purchase of a viral load testing machine and related equipment. The machine is a CAP/CTM manufactured by Roche. This piece of medical equipment measures the amount of a virus in a blood sample and is critical in the fight against the spread of HIV/AIDS. The equipment is also a useful tool for early infant diagnosis (EID) of HIV in infants born to an HIV positive mother and also used for Hepatitis B and C viral load monitoring and testing. It is the most advanced and complex piece of medical equipment at the Faith Alive Hospital in Jos, Nigeria. To understand how transformative this equipment is to the Faith Alive Hospital, first a little background.
When a patient becomes infected with HIV, particularly HIV1, the virus actually hijacks some of the immune system’s regenerative abilities and abuses those abilities to reproduce and spread HIV itself. So as the immune system fails, the HIV viral level or “load” will increase. The higher the viral load level, the more susceptible to other illnesses and the chances of the patient transmitting the virus to another person becomes more likely. Patients, who test positive for the HIV virus are most commonly put on a regimen of antiretroviral (ARV) drugs to combat the virus. These drugs, when effective, drive down the HIV viral load, allowing the patient’s natural immune system to rebuild itself and lessen the chance of transmission. Because HIV is a chronic condition, it never fully leaves the body, so treatment must continue for the life of the patient.
Rapid ability to diagnose and periodically monitor a patient’s viral load is extremely important for many reasons:
1. Allowing the doctors to initially accurately prescribe the correct dose and combination of ARV drugs.
2. Setting a baseline load to serve as a reference point as treatment continues.
3. Enabling the monitoring of the treatment’s effectiveness at halting the spread of the HIV virus throughout the immune system.
4. Periodically re-assessing the ability of the drugs to drive down the viral load to a level where the patient’s immune system can rebuild and they can live a more normal life.
5. Permitting or adjusting of the dose and combination of drugs as necessary to maintain low viral loads with a lower dosage to prevent drug resistance.
6. Providing early intervention treatment for EID: children born by HIV positive mothers)
7. Reducing response time for drug failure
As you can imagine, a single patient will require many periodic tests during their life to make sure the treatment is continuing to be effective.
Faith Alive’s viral load testing ability is unique in Plateau state. The procurement of the machine was done with joint financial help from Faith Alive USA and Aids Prevention in Africa (APIN). Prior to machine’s arrival, blood samples would be tested manually or would have to be sent to outside labs, costing money, causing sample spoilage when the cold chain storage link is broken, and driving delays affecting the quality of such samples . The nearest labs were in Abuja over 6 hours drive away over rough roads. To put this in perspective, Jos has a population of about one million people and Plateau state is about three million. So it is like the whole state of Oregon needing to send nearly all of its blood samples to California for testing. Keep in mind that the infection rate in Nigeria is at least ten times the rate in the USA.
The installation of this machine at the Jos hospital has been tremendously beneficial to efficiently process all the Faith Alive hospital’s blood tests and allow rapid retesting and reassessment of the patient. All of these tests are done for free by the hospital. But there have been other benefits as well. The machine has also become the cornerstone of the Center of Excellence at the Hospital, allowing Faith Alive Nigeria to provide testing services to the entire Jos and Plateau state region and even outside Plateau State as well. Private hospitals and the Jos University Teaching Hospital are willing to pay for testing services provided locally. This income helps subsidize the ability of Faith Alive to provide free medical care to anyone who enters its doors. As HIV/AIDS, Hepatitis, and EID are serious problems in Nigeria, this broadens the reach of Faith Alive’s equipment.
The machine itself and its supporting equipment are quite impressive, occupying about two large rooms of the hospital. The installation of the machine required upgrading hospital infrastructure to supply the power and refrigeration needed to run the machine and store and preserve the blood samples. The machine also required very specific technician training at Faith Alive to run and maintain the machine as well as to move record keeping to a new level.
We are thankful to all of the donors who made this investment possible. The viral load testing equipment has brought tangible improvement to the quality of care rendered to the Jos patient community and has allowed the staff to more effectively serve the poor and afflicted. This enables all of us to fulfill Jesus’s commandment in Matthew 22:39.