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Year : 2015  |  Volume : 33  |  Issue : 1  |  Page : 187--189

Four year data from an ICTC of a tertiary care hospital in Jaipur, Rajasthan

ER Sabharwal 
 Department of Microbiology, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India

Correspondence Address:
E R Sabharwal
Department of Microbiology, Mahatma Gandhi Medical College, Jaipur, Rajasthan
India

How to cite this article:
Sabharwal E R. Four year data from an ICTC of a tertiary care hospital in Jaipur, Rajasthan.Indian J Med Microbiol 2015;33:187-189

How to cite this URL:
Sabharwal E R. Four year data from an ICTC of a tertiary care hospital in Jaipur, Rajasthan. Indian J Med Microbiol [serial online] 2015 [cited 2020 Jul 5 ];33:187-189
Available from: http://www.ijmm.org/text.asp?2015/33/1/187/148439

Full Text

Dear Editor,

Human immunodeficiency virus (HIV) infections were reported to be about 33 million worldwide, of which an estimated 2.5 million people were in India at the end of 2006. [1] The epidemic is still going upswing and it is important to control it. The most effective approach available for the prevention and control of any infection/disease is awareness generation and lifestyle changes. The general consensus among those fighting AIDS worldwide is that HIV testing should be carried out voluntarily, with the consent of the individual concerned. This view has been completely endorsed in principle and action by the Indian government and NACO, who have thus established hundreds of voluntary counselling and testing centres (VCTCs), now the Integrated Counselling and Testing Centre (ICTC) in India.

The ICTC is a part of HIV prevention programme and is a place, where a person gets counselling and testing done, on his own will, or as advised by a medical provider. This is the entry point for comprehensive HIV care and treatment, as well as prevention. Hence awareness and acceptance of ICTC services is vital, if the HIV/AIDS epidemic is to be controlled. [2]

The present study was conducted at the ICTC of the microbiology department of Mahatma Gandhi Medical College, which is a tertiary care hospital catering to the needs of Jaipur and adjoining districts, to find the prevalence of HIV among ICTC attendees. The study included all attendees of the ICTC referred from various departments and surrounding hospitals or direct walk-in attendees from July 2009 to June 2013. After obtaining informed consent and pre-test counselling, a blood sample was withdrawn and subjected to three rapid HIV tests (Immunocomb J Mitra and Co. Pvt Ltd, Delhi, India, SD BIOLINE HIV-1/2 3.0, Standard Diagnostics, Inc. Korea and PAREEKSHAK HIV 1/2 Triline Card Test, Bhat Bio-Tech India Pvt Ltd.) following the manufacturer's instructions. Samples showing positive test results in all the three tests were declared HIV positive. The laboratory participates in stringent quality control measures, both internal and external. It receives samples for external quality assurance from the zonal reference laboratory on a quarterly basis. Data was summarised using percentage and analysed.

A total of 8190 clients accessed ICTC services during the study period, out of which 135 were HIV-seropositive, giving a prevalence of 1.64%. There was only a single positive case for HIV 2. About 95% (7780) of the attendees were referred by the practitioners while only 5% were direct walk-ins. Out of total clients tested, 5487 (67%) were males, whereas females constituted 2703 (33%). A majority (88.3%) of those who were HIV-seropositive were between the ages of 15 and 49 years. Heterosexual behaviour was the most common mode of transmission (92%) of the HIV infection among our subjects. The least common risk behaviour patterns were infected blood and blood products (0.8%), homosexual behaviour (0.5%), and nil through infected needles and syringes.

HIV counselling and testing services are a key entry point for prevention of HIV infection and treatment and care of people who are infected with HIV. The HIV prevalence in our study (1.64%) is quite similar to that reported by another study in Western India. [3] However, it is lower than the estimates provided by studies conducted in Karnataka (9.6%), West Bengal (17.1%), and Gujarat (4.8%). [4],[5],[6]

There was only a single positive case for HIV-2, giving a seroprevalence of 0.01% and none was reactive for antibodies of both HIV-1 and HIV-2. All the seropositive clients were referred to the antiretroviral treatment (ART) centre for care and management after the post-test counselling. Since the first evidence of HIV-2 infection in India in 1991, studies from different parts have shown a varied seroprevalence. Studies conducted in Delhi and Pune have revealed almost similar HIV-2 sero positivity of 0.03% each. [7],[8] Data from South India showed a prevalence of 0.13-1.8%. [9]

While the figures in our study could mean genuine lower seroprevalence, it could also mean a gross under utilisation of the ICTC services by the high-risk populations. Another disturbing finding in the current study was a very low percentage of direct walk-ins, which could be due to strong social taboo present in the community regarding HIV. Self-stigma and fear of discrimination are often central to individuals not seeking HIV tests or treatment. Both these observations bring us to the same conclusion that it is extremely important to raise awareness by aggressive health education programmes and also to make it more acceptable by integration of ICTC into various community organisations.

References

1NACO News, behind the numbers. Newsletter of National AIDS Control Organization. Ministry of Health and Family Welfare (GOI) 2007;3:4.
2National AIDS Control Programme CMIS Bulletin. Govt. of India. Ministry of Health and Family Welfare ICTC 2007:13-7.
3Vyas N, Hooja S, Sinha P, Mathur A, Singhal A, Vyas L. Prevalence of HIV/AIDS and prediction of future trends in north-west region of India: A six-year ICTC-based study. Indian J Community Med 2009;34:212-7.
4Gupta M. Profile of clients tested HIV positive at a voluntary counselling and testing centre of a district hospital in Udupi. Indian J Community Med 2009;34:223-6.
5Joardar GK, Sarkar A, Chatterjee C. Profile of the attendees in the voluntary and testing centre of North Bengal medical college in the Darjeeling district of West Bengal. Indian J Community Med 2006;31:237-40.
6Sharma R. Profile of attendee for voluntary counselling and testing in the ICTC, Ahmadabad. Indian J Sex Transm Dis 2009;30:31-6.
7Kashyap B, Gautam H, Bhalla P. Epidemiology and seroprevalence of human immunodeficiency virus type 2. Intervirology 2011;54:151-5.
8Tadokar VS, Kavathekar MS. Seroprevalence of human immunodeficiency virus type 2 infection from a tertiary care hospital in Pune, Maharashtra: A 2 year study. Indian J Med Microbiol 2013;31:314-5.
9Murugan S, Anburajan R. Prevalence of HIV-2 infection in South Tamil Nadu. Indian J Sex Transm Dis 2007;28:113.