Viral load assessment facilities and CD4 (Cell Count) test prerequisite for timely diagnosis of HIV among people inflicted with the same is yet to be made available in any of the public sector hospitals across Sindh province.
The Programme Manager, Enhanced HIV/AIDS Control Programme for Sindh, Dr Sharaf Ali Shah, responding to queries raised by local doctors and an American expert of Pakistani origin, during latter's presentation at Dow Medical University (DMU) here on Thursday said the facility is presently available only at private sector (Aga Khan Hospital against a cost of Rs 12,000, non-affordable for large majority of people.
The scenario, it was observed by the medical community present on the occasion, was not only hampering a fool proof mechanism to ascertain whether an individual is actually inflicted with the deadly virus or not but also denying him or her of timely drug therapy beneficial to improve their quality of life.
Dr Shah, however, observed that the concerned authorities are fully conscious of the fact and that assistance of Sindh Institute of Urology and Transplantation (SIUT), well equipped to undertake wide range of viral load tests, would soon be sought.
Latter talking to newsmen, he said that kits for the CD4 and viral load assessment tests, costing not more than Rs 100,000 to Rs 200,000 will be provided to the SIUT for making the procedure workable there and this could be arranged under the Enhanced AIDS Control Programme in next two months.
He also hoped that full arrangement for such diagnostic procedures would be made available with the programme itself by the end of the current year.
Dr Shehla Baqi, the guest speaker also presented her article under the title of "Treatment of the HIV Infected Patient."
In this context she reminded that viral transmission through blood is 100 percent and that in case of physical promiscuity chances are more in male to female contact.
These factors hold particular relevance to Pakistan where faulty blood transfusion system coupled with high prevalence of intra-venous drug addiction, instances of needle prick injury and vulnerability of unassumed wives are considerably high.
Dr Baqi explicitly discussing the Highly Active Antiretroviral Therapy (HAART) said that clinically it aims prolongation of life and more importantly the life quality Virologically it was said to be reduction in viral load ultimately delaying the worse and Epidemiologically to reduce HIV transmission.
Therapeutic aspect of the HAART was said to be the most significant as it not only helps to maintain therapeutic option and minimise side effects and 'toxicity but also to maximise adherence.
Strict and absolute adherence to prescribed drug therapy, the speaker said was extremely essential to make it propitious for the patients as otherwise they are prone to develop resistance to the drugs.
She also underscored need for easy and constant availability of drugs. This, however, was questioned by Pakistani doctors who reminded that Antiretroviral agents are not easily available in Pakistan compelling many of the concerned physicians to opt for a "Stop -Start" strategy in accordance to availability of drug or shifting from one class o-f drug to another drug with enhanced risk of resistance among the patients.
The speaker reminded that constant progress has been made in the field of Antiretroviral agents during last several years and patients are presently provided with options with comparatively little side effects, minimum possible complications and above all quality as well as prolongation of life.
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