The Viral Load Cohort North-East Lesotho (VICONEL) seeks to strengthen HIV clinical management in Lesotho and generate scientific evidence to advance the quality of care and improve health outcomes for people living with HIV in southern Africa and beyond.

VICONEL is a prospective open cohort that systematically captures routine viral load test results, demographic information, and treatment data of over 30’000 people receiving HIV care in clinics in three districts of Lesotho (see published cohort profile). Available data allows for monitoring of both treatment outcomes and health system performance. A biobank facilitates further research with routinely collected blood samples of consenting participants, increasing responsiveness to emerging public health concerns (such as SARS-CoV-2 and emerging drug resistance). Finally, VICONEL constitutes an ideal platform for the integration of nested projects, including observational studies as well as randomised trials-within-cohort (TwiCs).

With current focus areas including detection and management of drug resistance as well as the needs of older people with HIV, VICONEL contributes essential evidence to inform national and global strategies for HIV management.