Mumbai: HIV testing for children born to positive mothers has stopped or slowed down in many states, including Maharashtra, for three months due to the unavailability of early infant diagnostic (EID) kits. Statistics show over 50 per cent of kids with HIV die within two years if untreated.
When contacted, a senior NACO official in Delhi cited “time taken to get an exemption to import the kits”. The rule is reportedly to seek a made-in-India product wherever possible, but EID kits are not locally made. “We have placed an order with a US firm and the kits should arrive in a couple of weeks,” the official said.
HIV testing centres assured kits would arrive by December first week
Early infant diagnostic (EID) kits, used for HIV testing for children, have not been available for at least three months, an official from the Maharashtra State Aids Control Society (MSACS) said. The idea of testing children as young as six weeks is to get an early diagnosis and start them on life-saving drugs.
Samples from Mumbai, Gujarat and Madhya Pradesh are sent to the BMC’s molecular diagnostic laboratory in Kasturba Hospital, near Chinchpokli station, while samples from the rest of the state go to National AIDS Research Institute (NARI) in Pune.
A BMC health official said the Kasturba labs have not been able to test 650 filter papers with a dried blot (see box) of the blood of a child born to an HIV-positive mother. The lab, which tests roughly 5,000 samples annually, has had to throw away scores of dried blots, which have a shelf life of six weeks.
The country-wide shortage was discussed in a recent meeting held by the National Aids Control Organisation (NACO), the central agency overseeing the country’s HIV programme.
“Testing centres have been assured that kits would arrive by the first week of December,” the official said.
NACO’s Prevention of Parent to Child Transmission programme has been praised, with pregnant women with HIV getting antivirals to prevent transmission to their children. From a transmission rate of 24 per cent a decade back, the mother-to-children transmission rate across India has dropped to around 8 per cent . In cities such as Mumbai, the success rate is better.
However, the country’s HIV/AIDS programme came in for widespread criticism during the Covid pandemic, with shortages of kits and the three-drug Dolutegravir combination pill in July.
“The delay in placing an order for EID kits is shocking considering children’s lives are at stake here,” said a doctor working in the field of HIV/AIDS. However, doctors are innovating at the ground level.
An MSACS official said in the absence of DBS testing, they have had to take some contingency steps. “Doctors are being told to start treatment for a symptomatic baby born to an HIV-positive mother,” he said.
Also, if the mother had a high viral load during pregnancy, the child is considered to be high risk and started on antiviral syrups Zidovudine and Nevirapine to cut down transmission risks.
The officer explained that newborns are screened at six weeks, six months and 12 months using the DBS test. If any of these tests come positive, a repeat test is carried out. “A final confirmatory test is carried out at 18 months to determine if the HIV has been transmitted from the child to the mother,” he added.