Flawed HIV test, Human rights commission served noticed to WB DHS

[Guest guest]

Thanks to flawed hospital tests, HIV hits home

Son transmitted virus to mother during blood transfusion, family

blames hospital for neglect

Subrata Nagchoudhury

Bhatar (Burdwan), June 1: MARCH, 1 2001 is a day etched in blood and

stone for the Ghosh family of Ara village in Burdwan district. It was

the day three words changed the lives of the family forever, the day

blood test reports from Kolkata's School of Tropical Medicine landed

in their hands, telling them that Gopali Devi and her son Paran

were ``reactive to HIV-1.'' Or simply, they were HIV positive.

Mother-child transmission isn't unusual, particularly during

childbirth. But Gopali Devi, who is in her mid-sixties, has

contracted the virus during a blood transfusion from her son.

Inquiries point to suspected negligence by the government run Burdwan

Medical College Hospital, where Gopali Devi was given a transfusion

of blood taken from 27-year-old Paran, who was later diagnosed as HIV

positive.

Gopali Devi has now moved the West Bengal Human Rights Commission

(WBHRC) seeking compensation of Rs five lakh from the hospital. The

commission has served notices to the Director of Health Services,

Chief Medical Officer (Health) of Burdwan and the Superintendent of

the Burdwan Medical College and Hospital, seeking explanations from

them.

When Gopali Devi was admitted for a gall bladder surgery at Burdwan

hospital in July last year, her son Paran, a truck driver in Delhi,

came back to the village. On July 14, a day before the operation,

doctors wanted two bottles of blood for Gopali Devi's operation.

Paran (27) and Parimal—the youngest of Gopali Devi's three sons —

matched her blood group and volunteered. At the time, the blood

donated by Paran was cleared by the hospital's blood bank.

After the operation, Paran returned to his job. While in Chennai, he

fell ill, and a medical test showed he was HIV positive. He returned

to his village and died on March 9, just eight days after being

declared positive.

Dr Tamal Ghosh, associate professor of the Department of Pathology of

Burdwan Medical College and the medical officer in charge of the

hospital's blood bank, claimed that blood samples taken from Paran

had undergone the mandatory examinations under the ``rapid test

method'' for HIV, HBsAG, VDRM and MP, all of which tested negative.

The hospital did not have a sufficient inventory of pre-tested blood

for conducting the test, he said. In any case, he said, there

is nothing wrong with the ``rapid test''.

Dr Ghosh explained that there are chances that Paran might have been

carrying the HIV virus, but might not have developed the AIDS

antibody. During the `window period' — as the lag between contracting

the HIV infection and the growth of the AIDS antibody is known — a

patient may not test HIV positive in blood samples. This window

period may extend from six to 36 weeks for a HIV infection to develop

into a full-blown case of AIDS, says Dr Ghosh.

This medicalese is now meaningless for the Ghosh family. They are

convinced that Gopali's fate could have been avoided had the hospital

authorities been more cautious. Since Paran, a truck driver, fell

into the high risk group, ``the hospital should have taken care,''

said Sukumar Ghosh, Gopali's husband. Besides, argues Jobin, their

eldest son, the period between Paran's blood donation and his death

is too short to suggest that the disease was in its early stages. He

feels a proper test would have recorded the disease.

``Instead of a cure, my mother has come back from the hospital with

this killer disease. Ever since the detection, we have been spending

Rs 5,000 per month for my mother. We can manage only for a couple of

months more, but later, we'll turn into paupers,'' says Jibon.

As the family waits, Gopali Devi seems to be rapidly shrinking

away. ``I can hardly do any work in the house. I always feel

exhausted and feverish. Often, there are boils on my body. My sons

are doing whatever they can,'' she said. If there's any silver

lining, it's that the family has not been ostracised by their

neighbours in Ara village. ``But when Paran died, villagers

maintained a distance. Many of them said it is a foreign disease and

very infectious. We did have a problem cremating him.'' said

Jibon. ``Fortunately for my mother, there is no such feeling in the

village till now.''

Doctors at the School of Tropical Medicine, where she's undergoing

treatment, have advised Gopali Devi not to cut vegetables or do

anything that might cause a blood injury. For the family, the WBHRC's

intervention is the only hope that even if they can't save Gopali

Devi's life, they could at least delay her death.

_______________________________

http://www.indian-express.com/ie20010602/nat19.html

[Guest guest]

Well I am an HIV specialist practising in the US in a large HIV

clinic in Houston Tevas.

I would like to state that in this case, the son clearly had to

have had the antibodies positive for HIV as he had AIDS atleast

by the criteria of CD4 cells being <200 cells, a year before he

died.

Normally the Cd4 cells decline 100-200 cells per year and at the best

he had have been positive atelease for 5 years if not more. Therefore

the question of WINDOW period is absolutely irrelavent as he I am sure

had been positive for sometime. there clearly are false negative tests

with rapid tests and for Blood samples there should be ELISA done on

every sample.

Fehmida Visnegarwala, MD

Assistant Professor of Medicine

#424, 2015, Street,

Houston Tx-77009

Phone: 713-793-4069

Fax: 713-793-4047

E-mail: <fehmidav@...>