Essential in vitro diagnostics for advanced HIV and serious fungal diseases: international experts’ consensus recommendations

Abstract

An accurate, timely diagnosis is the cornerstone of good medical practice. For opportunistic fungal infections in AIDS and other invasive mycoses, this is dependent on the availability of and accessibility to the relevant diagnostic tests. A call for a model List of Essential in Vitro Diagnostics (EDL)— “listed tests that should be reasonably available for people who need them, whether in the form of point-of-care tests in physicians’ offices and pharmacies or as high-complexity tests in reference laboratories”—has been published [1]. In addition to better medical practice, other potential benefits of an EDL include clarification of priorities for policy makers, setting common goals for laboratory testing, improved healthcare delivery and overall better patient outcomes [1]. In the context of extensive antimicrobial resistance (AMR), a reduction in empiricism with more accurate diagnosis will play a key role in AMR control [2]. Globally, 37 million people are living with HIV [3], over a third of whom present or return to care after treatment interruption with advanced HIV disease defined as a CD4 cell count < 200 cells/mm3 or a World Health Organization