NE NGOs call for access to 'viral load' monitoring to improve HIV treatment
Source: Hueiyen News Service

Guwahati, February 20 2014 : With over half a million people living with HIV in India on treatment, viral load testing � the best tool to monitor treatment � is not easily accessible and available.

Community Network for Empowerment (CoNE), Manipur, has expressed concern over the strict rationing of testing by the State AIDS Clinical Expert Panel (SACEP) and has called on the Department of AIDS Control (DAC) to scale up and expand access to viral load tests in the country.

The latest World Health Organization HIV treatment guidelines call for people living with HIV on antiretroviral drug regimens to receive a viral load test once a year to ensure their treatment is working, and to identify those who are either failing treatment, and must be switched to a different regimen, or need extra adherence support to get back on track.

"Viral load tests are being strictly rationed in India and people living with HIV in the North-East who are failing their first line antiretroviral therapy who are very sick can just die just waiting for access to a viral load test to confirm their treatment failure," said Rajkumar Nalinikanta, President, CoNE Manipur.

"We are calling on DAC to respond to the situation in the North East.

The need of the hour is to reduce the bureaucracy in SACEP to access a viral load test, as patients face unnecessary delays in their clinical assessment" .

Viral load tests determine the amount of virus in a patient's blood and can better monitor how someone is responding to treatment on antiretrovirals (ARVs).

If levels are found to be 'undetectable' the drugs are suppressing HIV as they should.

But an elevated viral load indicates a problem.

A viral load test is much more accurate at detecting problems than CD4 testing, which is currently being used as the primary treatment monitoring tool in the country.

In a regional meeting held yesterday in Guwahati attended by representatives of people living with HIV from seven North East states (Manipur, Nagaland, Mizoram, Meghalaya, Sikkim, Assam and Arunachal Pradesh) a demand was made by PLHIV networks to have their treatment monitored via viral load testing at least 'once a year' .

Currently, DAC's policy on viral load follows a very narrow and targeted approach reserving it only for those patients on HIV treatment who are in the last stages of failing their first line antiretroviral therapy with opportunistic infections already setting in and threatening their lives.

"But monitoring treatment with viral load testing can also help to resolve adherence problems by taking corrective measures early on instead of waiting till drug resistance sets in.

It can make a huge difference to our lives if we know that the medicines are working and our status is undetectable the virus in our bodies is under control.

We can then lead a normal and healthy life and plan for tomorrow," said Malsawmdawnga from Mizoram people Living with HIV/AIDS Society (M-PLAS) .

"With DAC rolling out HIV treatment for nearly a million people living with HIV, a solution for treatment monitoring is an absolute necessity in India and a scale up of viral load testing should be a priority.

In the long run, the additional costs of viral load monitoring will be offset by decreased requirement for CD4 evaluation and reducing the need to escalate patients to more expensive second or third line drug regimens," said Leena Menghaney, Campaign Coordinator, MSF Access Campaign.

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