Denial of ART at IGMC Shimla. Is ART to be statred after USG?

[Guest guest]

Dear Forum,

There seem to be some strange guidelines on ART. I got feedback from

some patients that ART is not being started even after CD counts of 196.

They are told that ART will start after USG test. When they got to get

the USG test done, they are given an appointment after two weeks to one

month. They are not likely to survive this period without ART.

Will someone shed light on the rationale of the precondition for USG. Is

is part of the national or international protocol?

What can be done to solve this crisis?

Rajesh.

e-mail: <drrksood@...>

[Guest guest]

Dear all

Re: /message/9052

Let us be clear on this issue. NACO guidelines on ART are available on website,

are given to all MOs in Training , have been sent to all ART centres and our

training modules also have these guidelines.

The guidelines clearly give what investigations are to be done as baseline in

all patients, what investigations are to be done in selected cases depanding on

symptoms etc. An Abdominal Ultrasound is not a part of baseline investigations

to be done in all patients.

It is to be done only in cases where we are suspecting abdominal TB due to

history of prolonged fever, weight loss or other symptoms that require TB to be

ruled out or some other pathology suspected in abdomen. In asymptomatic patients

, there is no need to do an ultrasound as a routine and thus delay ART due to

USG.

I hope the guidelines are clear to all and need to be followed by all ART

centres.

Thanks

Dr B.B.Rewari. MD,FICP,FIACM,FIMSA,FGSI

Sr.Physician,Dr RML Hospital & National Programme Officer (ART)

National AIDS Control Organistion,

6th Floor, Chandralok Building,

36, Janpath, New Delhi-110001

Tel; 011-43616677,23731954(O)

Mobile ; 91-9811267610

Fax : 011-23731746

e-mail: <drbbrewari@...>