The Mumbai AIDS Control Society (MDACS) has intensified efforts to track patients who have left treatment midway in the past five years. The society has started ‘Mission Sampark’ to trace 849 ‘LTFU’ cases. Loss to follow-up (LTFU) cases can result in increased HIV-related deaths and these patients are also a public health concern because they can spread the disease in the community.
More than 800 patients need to be traced
“When patients drop out, they are no longer monitored by the antiretroviral treatment (ART) centres, making it difficult to trace them. The number of lost to follow-up cases had come down but there are still more than 800 such patients who need to be traced,” an official said.
Dr Vijaykumar Karanjkar, deputy director, MDACS, said proper follow-up, counselling and availability of drugs that have fewer side effects are reasons behind the decrease in dropout figures.
Decrease in cases after rigorous follow-up
“We have traced 40% of the 849 LTFU patients [so far]. We will intensify our campaign to track down all patients. Meanwhile, we have also informed care support centres to rigorously follow up newly registered People Living with HIV (PLHIV). Additionally, our counsellor will call up the patient within 48 hours of either missing a follow-up, investigation or picking up medicines,” he said.
Dr Karanjkar said it is a good sign that after a rigorous follow-up, there is a decrease in such cases. The confidence of people in treatment at government hospitals is also increasing he said. Another concern is that if patients abandon treatment midway, they could develop drug resistance.
“Stopping the treatment means you are allowing the virus to acquire drug-resistant forms. Treatment options for advanced forms of the infection are largely limited,” said a doctor from Sir JJ Hospital, Byculla.
6000 families affected by virus
Doctors said there were several reasons why patients abandoned medication. “They usually do not disclose their condition to their relatives. Many discontinue the treatment out of the fear that others will find out about their condition,” said one doctor.
MDACS has also started family-centric care at the ART centre to improve early diagnosis, and treatment retention and reduce default in HIV couples. The society has 6,000 families affected by the virus out of which 29% failed to adhere to the treatment.
“In some families, the HIV family members are taking treatment in different centres. We therefore thought of getting them treated in one centre for a better outcome and coordination,” said an MDACS official.
When patient stops treatment, virus multiplies in body: Dr Gilada
Dr Ishwar Gilada, secretary-president of the AIDS Society of India and governing council member of the International AIDS Society, said: “The health authorities are also doing well in terms of tracking and counselling. However, some people do not adhere to treatment and the only thing we can do is make them understand.”
“When an HIV patient stops the treatment, the virus multiplies in their body. This patient will knowingly or unknowingly spread the infection in the community either by unsafe sex or use of common syringes,” he said.
