New Delhi: The National AIDS Control Organisation (NACO), the implementing agency for government’s HIV/AIDS programmes, will scale up testing for second line of treatment from 10,000 patients a year to 1 million. The test, called viral load testing, will be outsourced to private laboratories.

“We can handle tests for a limited number of people. When the increase is of such a scale, then the government laboratories cannot handle it alone," said Naresh Goel, deputy director general, NACO.

So far, only those patients who failed to respond to the first line of treatment, were referred to viral load testing. The number of such patients is around 10,000 per year. But in a decision taken last year, the government decided to test all HIV positive patients once a year to check if they are responding to first line of treatment, part of the anti-retroviral therapy or ART offered by the government. According to a report by UNAIDS, the United Nations programme on HIV/AIDS, 2.1 million Indians in 2013 had HIV/AIDS.

“Instead of waiting for doctor’s observation till the medicines stop to treat, we will know faster whether the first line medicines suit the patient or not," said Goel.

Patients stop responding to first line of treatment when they develop resistance to certain drugs. Under ART, they are then started on the second line of treatment, which consists of different drugs. The third line of treatment is still to be offered by government, though it is available privately.

“All evidence and literature shows that the sooner a patient is put on treatment that suits them, the longer is the person’s life. For this, early detection of patient’s resistance to first line of treatment is crucial. This move will reduce mortality among HIV patients to a great extent," he said.

The standard method followed by NACO for testing a person’s HIV status is through CD4 tests. It checks whether a patient has antibodies, which are formed as a result of the presence of the AIDS virus.

“This is an indirect method of testing for HIV. We have seen many cases in which CD4 results were in contradiction to the HIV status of a patients," said Paul Lhungdim, Project Coordinator, The Delhi Network of Positive People, an organization of HIV positive patients in Delhi.

Viral load testing, on the other hand, tests the load of the AIDS virus in a person, giving an accurate picture of the patient’s status. It helps doctors determine whether to put the patient on the first line or second line of treatment under ART.

NACO has 272 CD4 testing laboratories but only 10 viral load testing laboratories, supervised by the Laboratory Services Division of the organization.

NACO has received tenders from various laboratories like SRL Diagnostics and Dr Lal PathLabs. “We are analysing the tenders and will declare the results soon," said Goel.

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