The CD4 count is a vital parameter that measures the human immune system.
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An acute shortage of CD4 (cluster of differentiation 4) test kits in Karnataka has hit people living with HIV/AIDS hard for the last six months.
The CD4 count is a vital parameter that measures the immune system. A low CD4 count means HIV has weakened the immunity. Before being initiated into the first line of ART (antiretroviral therapy), screening is done not only to identify the combination of drugs but also to deal with the side effects of the toxic multi-drug therapy.
Although the State has been following a “Treat All” policy since 2017, which mandates free ART initiation irrespective of the CD4 count, new patients in several districts (including Chikkaballapur, Dharwad, Athani, Gangavati, Ramanagara, Yadgir and Mudhol) are finding it hard to get the treatment without the test. Besides, those already on treatment are anxious as the monitoring of their immunity is affected.
December 1 is observed as World AIDS Day.
Over 50 CD4 machines
The State has over 50 CD4 machines of three different brands — 27 Sysmex, four Alere Pima and 20 BD Presto machines — that are in working condition. While the National AIDS Control Organisation (NACO) is supplying test kits for the former two brands (Sysmex and Alere Pima), it has asked the Karnataka State AIDS Prevention Society (KSAPS) to procure test kits of BD Presto locally. KSAPS officials said the shortage is due to delays in local procurement.
Patients in some districts said their CD4 count has not been tested for months. “It helps determine treatment plans and monitors the effectiveness of ART,” said Rekha, a transgender who lives with HIV in a village in Davangere district.
“Without regular CD4 tests, we are at greater risk of opportunistic infections, especially tuberculosis (TB). It creates uncertainty and stress, which in turn reduces the count again,’’ said Mallika Shivahalli from Bagalkot, who has been living with HIV for the past 12 years.
Local procurement
Acknowledging the shortage, KSAPS Project Director Nagaraja N.M. told The Hindu that the 20 centres that have BD Presto machines have been mapped with other nearest centres that have CD4 machines. “Samples from the 20 centres are being sent to the other nearest centres, and testing is being done. It has not affected the patients, as irrespective of the CD4 count, their treatment is continuing,” he said.
Mr. Nagaraja said money has been allocated for the local procurement, and the issue will be resolved within a week to ten days. “These test kits are proprietary items of the company. The procurement process is underway, and the issue will be resolved soon,” he said.
HIV TPR declining
The HIV test positivity rate (TPR) in Karnataka, which has been one of the top three States with the highest number of people living with HIV, has been on a declining trend since 2017.
The HIV TPR in women under antenatal care (ANC) has reduced from 0.06% in 2017-18 to 0.03% in 2024-25 (till October end). In general clients tested at the Integrated Counselling and Testing Centres (ICTCs), it has dropped from 0.85% in 2017-18 to 0.33% in 2024-25 (till October end).
According to data from the Karnataka State AIDS Prevention Society (KSAPS) in 2023-2024, as many as 39,81,572 general clients were counselled and tested with a positivity rate of 0.33% and 14,43,896 women under ANC were counselled and tested with a positivity rate of 0.04%.
In 2024-2025 (till October end), 23,15,909 general clients were counselled and tested with a positivity rate of 0.33% and 7,11,510 women under ANC were counselled and tested with a positivity rate of 0.03%.
(Names of patients have been changed)
Published – November 30, 2024 09:28 pm IST
