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  5. Performance Measure: HIV Viral Load Suppression

Performance Measure: HIV Viral Load Suppression

National Quality Forum #: 2082 / 3210e

Description: Percentage of patients, regardless of age, with a diagnosis of HIV with a HIV viral load less than 200 copies/ml at last viral load test during the measurement year

Numerator: Number of patients in the denominator with a HIV viral load less than 200 copies/ml at last HIV viral load test during the measurement year

Denominator: Number of patients, regardless of age, with a diagnosis of HIV with at least one medical visit in the measurement year

Patient Exclusions: None

Data Elements:

  1. Does the patient, regardless of age, have a diagnosis of HIV? (Y/N)

    1. If yes, did the patient have at least one medical visit during the measurement year? (Y/N)

      1. If yes, did the patient have a HIV viral load test with a result <200 copies/mL at the last test? (Y/N)

National goals, target, or benchmarks for comparison

This HIV/AIDS Bureau measure aligns with the following national indicators:

The annual Ryan White HIV/AIDS Services Report (RSR) captures national and state-level data regarding related measures such as HIV Viral Suppression and Annual Retention in Care. HRSA releases an RSR publication each year, which provides an in-depth look at demographics and socio-economic factors among clients served. Learn more about the quality payment program.

The Ryan White HIV/AIDS Program (RWHAP) Compass Dashboard displays aggregate-level RSR data and provides users an opportunity to interact with and visualize the reach, impact, and outcomes of the RWHAP. The RWHAP Compass Dashboard also visualizes information about RWHAP services received and characteristics of those clients accessing the AIDS Drug Assistance Program (ADAP).

In addition, the HIV Quality Measures (HIVQM) Module is a tool within the RSR portal that allows recipients to enter aggregate data specific to the HRSA HAB Performance Measures. The HIVQM Module allows recipients to conduct point-in-time benchmarking across Ryan White HIV/AIDS Programs that use the module.

Department of Health and Human Services Clinical Practice Guidelines

Adult guidelines

"These guidelines and the AIDS Clinical Trials Group (ACTG) now define virologic failure as a confirmed viral load >200 copies/mL – a threshold that eliminates most cases of apparent viremia caused by viral load blips or assay variability (see Virologic Failure and Suboptimal Immunologic Response).

Individuals who are adherent to their ARV regimens and do not harbor resistance mutations to the component drugs can generally achieve suppression 8 to 24 weeks after ART initiation; rarely, in some patients it may take longer."1

Pediatric guidelines

"Based on accumulated experience with currently available assays, the current definition of virologic suppression is a plasma viral load below the detection limit of the assay used (generally <20 copies/mL to 75 copies/mL)."2

Use in other federal programs

References/notes

1 Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV (PDF - 5 MB). Department of Health and Human Services. Available online. Accessed August 2022. C-6 through C-7.

2 Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children. Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection (PDF - 5 MB). Department of Health and Human Services. Available online. Accessed February 2023. D-7.

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