India has 10 government laboratories in states including Maharashtra, Chennai, Delhi, Manipur, Pune and Tamilnadu equipped with viral load testing machines.
48-year-old Subodh (name changed) is hapless. He is on third-line anti-HIV drugs, which are his last hope of survival. His hospital papers indicate that the viral load tests were done for him in government-run Lok Nayak Hospital on March 23 2015, which were shooting up to 13,900 copies per ml. It has been nearing two years now that the viral load test on him has not been repeated.
"The viral load tests in HIV patients have to be done once in a year at least. The Central government's infrastructure for viral load testing is crumbling and inefficient. Therefore these tests are not happening on time for patients," said a senior official in Union Health Ministry.
India has 10 government laboratories in states including Maharashtra, Chennai, Delhi, Manipur, Pune and Tamilnadu equipped with viral load testing machines. "While earlier there were two machines in Delhi—one at All India Institute of Medical Sciences and another at Institute of Behaviour and Allied Sciences (IBAS), the facility is no longer available in IBAS. In Mumbai, state-run JJ Hospital had a machine which is currently not working," said the official.
A viral load test costs up to Rs 4,500 and a machine which conducts this test can cost anywhere between Rs 3-5 crore.
National AIDS Control Organization (NACO) has floated tenders to outsource the facility by getting into a Public-Private Partnership (PPP), as upkeep of government-run labs for viral load testing is not efficient, it claims. "The tenders for outsourcing tests to private labs will be finalised shortly. We are in end stages of finalisation," said Dr RS Gupta, Deputy Director General, NACO.
According to international guidelines, every patient on antiretroviral therapy (ART) drugs should get their viral load checked.
"We are unable to check viral load of patients due to shortage of testing kits and lack of infrastructure. At times, we do not have reagents or machine goes out of order," said senior doctor in a government-run ART clinic in Delhi. Patients are kept on drugs and viral load test is only done when their health deteriorates terribly, and they show symptoms like fever or co-infections like tuberculosis amongst others.
India has over nine lakh patients registered on ART treatment. Upto 15,000 patients who are in dire need of viral load testing are on second-line drugs. Also, 125 patients are registered on third-line drugs with NACO.
Dr George Oommen, HIV consultant with Holy Spirit Hospital in Mumbai said, "There are hundreds of patients on third-line drugs in private hospitals as well. The load of drug-resistant HIV patients is very high."
ideal procedure
The viral load tests in HIV patients have to be done at least once in a year.
In countries of Europe, treatment is only done after each HIV patient's viral load is tested.
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