Guidelines for CD4 testing by private providers

[Guest guest]

Dear All,

Some private providers in Andhra Preadesh, (AP) have initiated the testing of

CD4 for all patients who test positive in the VCTCs or PPTCTs/hospitals and

propogate that a baseline CD4 count is necessary for all persons testing

positive. the patients are being educated that a repeat CD4 is necessary every 3

- 6 months so that early ART can be intitiated

They are providing this at a highly subsidised rate at present, but

the catch is that this facility is available for a very limited

number of patients.

These providers further wish to initiate ART for all clients testing

less than 200 for CD4 with protocols that may not necessarily confirm to NACO

guidelines. The ART is being provided at subsidised costs after obtaining the

same from pharmaceutical companies.

While this is a very good initiative, I feel some caution is

necessary. Many patients who intiate the treatment on their own costs may not

be able to sustain the treatment for life. These would become a burden to the

government or discontinue the treatment with disastrous results.

Many clients who have an initial test at subsidised rate may want a

repeat at the same rate if they are borderline. If these providers

are unable to continue with the facility, all these clients would

become an extra burden to the state.

In a scenario where AP is already grappling with a huge burden for

testing and treatment we could do well without extra encumberances

such as these.

It is my request that Positive networks/policy making agencies/NACO

etc provide uniform guidelines for testing and treatment and ensure

that such guidelines are followed stringently

Ratna

e-mail: <ratna_devi2002@...>