Once the sample has been taken, in the case of HIV, it only remains to measure the concentration of CD4 lymphocytes as well as the plasma viral load. “These are the two best markers of the development of the disease. They make it possible to follow the development of the virus and the efficacy of the treatment during HIV infection”. If the viral load is high and the amount of TDC4 lymphocytes is weak, “this means that there is a rapid development towards AIDS and so questions need to be asked about the treatment administered”. The viral load must remain at the undetectable threshold, or less than 50 copies/ml. The problem is that the simplest technique is the least costly way of measuring the viral load; the ANRS technique is not practicable in countries with limited resources because it requires qualified personnel and sufficient laboratory infrastructures. This is why the Abbott RealTime method is preferred even though it is the most expensive. It is the technique of choice for countries with a strong genetic diversity like Chad because it detects sub-types of the M group (A-H), the N group, the O group and recombining forms. It does not require a specific qualification in molecular biology.

Finally, for a better care of people living with HIV, it is absolutely necessary to be able to carry out resistance tests to judge the effectiveness of the treatment. Yet again, the standard detection techniques for resistance mutations for the purposes of monitoring patients are very costly and require sophisticated equipment and trained personnel. “Here in Europe, we have carried out a complete sequencing of part of the gene to search for different resistance mutations. We have interested ourselves in an alternative method which makes it possible to detect an isolated mutation. It is the Allele-Specific PCR method (ASPCR)”. By using a metaphor, the technique can be explained in the following way: if we consider the European Union, Brussels represents its center. It is the heart of Europe. Consequently, there is no need to target the member states in order to reach Europe. It is only necessary to reach Brussels. This means that in relation to the subject we are discussing here, it is not indispensable to identify all the mutations present on part of the gene. It is rather a case of “identifying the leaders”. Their presence indicates that the treatment is not working. When the standard techniques only detect a mutation when it is in the majority and represents at least 20 % of the overall viral population, the ASPCR technique enables the detection of several resistance mutations in the same sample contained in a mixture even with a low-level proportion (0.01%).

The different alternatives exposed in Chatté Adawaye’s thesis go beyond their purely technical interest, they represent a real hope, that of “a healthy and normal life for people living with VIH and the eradication of the disease from the world on the other hand”. The idea of a normal life takes on its full meaning when you take account of the taboo that HIV represents in many countries including Chad. Indeed, having to face the looks of others while seeing no improvement in one’s condition does not inspire one to continue with treatment on a constant basis. This reality argues for a situation where care is not only a technical question, but that the disease is understood and those who are its victims accepted.