With change in national guidelines in May to ‘test and treat’ all HIV diagnosed patients, the Mumbai District AIDS Control Society (MDACS) has reached out to over 50 per cent of HIV untreated burden in the city to start their anti-retroviral treatment (ART). Officials claim they hope to put close to 8,000 HIV positive patients on ART in next two months through field workers and NGOs.
So far, only those with CD4 count — cluster of differentiation which is a type of white blood cells — less than 500 were put on ART treatment. Those with CD4 count above 500 were advised no active treatment but tests every six months. Based on the World Health Organisation’s (WHO) recommendation, the National AIDS Control Organisation (NACO) has revised guidelines making it mandatory to treat every patient diagnosed HIV positive.
“The aim is to reduce risk of infection or mortality related to HIV,” said Dr Shrikala Acharya, additional project director at MDACS.
ART clinics across Mumbai were asked to trace all patients who were registered as HIV positive but had not started ART. Health workers are currently counselling these patients to put them on free treatment. Those with HIV may remain asymptomatic for a long time until immunity dips making them prone to infections. Of 8,000 such patients, 50 per cent have now been contacted and counselled.
In addition, MDACS is taking extra measures to prevent mother-to-child HIV transmission by testing and treating all pregnant women registered in government hospitals and maternity homes across Mumbai. Since 2014, when the programme to treat each HIV positive pregnant woman began, the MDACS has helped prevent HIV transmission to 1,002 newborns.
The 2014-15 data, accessed by The Indian Express, showed 1.28 lakh pregnant women were screened in government centres, of which 521 were HIV positive. They were put on the three-drug treatment (tenofovir, lamivadine, efaverinz) and transmission was prevented in 506 babies (97 per cent). In 2015-16, 1.12 lakh women were screened and 503 women were put on three drug treatment. MDACS managed to prevent HIV transmission in 98 per cent babies.
“We also test a baby four times till he is 18 months old before declaring him HIV negative. The pregnant mother is put on life-long ART treatment to prevent infection spread chances,” Acharya said, adding that in only two per cent cases, the virus may transmit to the newborn from the mother despite treatment. Between 2014 and 2016, as many as 21 babies contracted HIV from their mother.
According to the WHO, early intervention can help prevent spread of HIV infection. After delivery, a mother is followed up for two years while the baby is administered Nevirapine drug for six to 12 weeks to avoid accidental virus transmission through breast milk.