Date:24/03/2004 URL: http://www.thehindu.com/2004/03/24/stories/2004032410800300.htm

Tamil Nadu - Chennai

Screening of HIV-positive persons begins

By Ramya Kannan

CHENNAI, MARCH 23. Doctors at the Government Hospital for Thoracic Medicine (GHTM), Tambaram, have started screening persons living with HIV/AIDS to identify beneficiaries for free anti retro viral therapy.

As part of a Central Government initiative to reduce the cost burden on positive persons, anti retro virals (ARVs) will be provided free of cost to them, irrespective of economic criteria.

Initially, it has been proposed to start 15 centres (five in Tamil Nadu) to provide these drugs. But, the project, in its abbreviated form, will commence in only one centre in the State - the GHTM.

Hectic preparations are on at the hospital to kickstart the programme on April 1. At present, more than 250 positive persons have been tested for CD4 count, which is indicative of the body's immunity. "As per World Health Organisation standards, any person who has a CD4 count less than 200 qualifies for free ARVs," according to S. Rajasekharan, deputy superintendent, GHTM. Following this, 100 beneficiaries have already been identified.

The hospital will also collaborate with positive persons' networks and non-Government organisations working in the sector to identify beneficiaries. "We have been asked to identify members whose CD4 count is less than 200. Since follow-up is essential for the continuance of the programme, it is believed that we can help with that," P. Kausalya of the Tamil Nadu Network of Positive Persons said.

"We are hoping for an adherence rate of 95 per cent. Only then will it be effective. There is no point in providing drugs if they are not taken as per schedule," K. Deenabandu, project director, Tamil Nadu State AIDS Control Society, said. Three drug combinations would be provided in two doses to all recipients, except for pregnant women who require a different regimen.

The project would follow a guardian support system for every beneficiary to ensure that patients took the two tablets for the specified period. " He or she will have to come back regularly for follow-up, for taking CD4 count tests. Viral load tests will also be done to find out if the drugs are working," Dr. Rajasekharan said.

In addition to providing drugs free of cost, a counselling centre will be set up to provide information and support for parents, guardians and their families.

Since the State intended to start the programme with 200 patients, it was likely that the number of positive persons requiring ARVs would be more than what the Government could accommodate initially. "Because of this, we will have to choose those who are in greatest need for ARVs and for whom it will be completely out of reach. We are forced to look for economic criteria, though the Central Government is not in favour of it," Dr. Rajasekharan said. "The others would have to be put on a waiting list. They would be accommodated as the scheme progresses. We hope to get the drugs from the Union Government by Monday."

He said those wishing to avail themselves of the scheme could report at the outpatient unit of the hospital. A CD4 count would be done immediately and the results available the next day.