In an official release last year, WHO said that ART should be initiated in everyone living with HIV, no matter what their CD4 cell count (CD4+ T cell is a type of white blood cell vital to fighting infection, and its levels are key indicators of the condition of the patient’s immune system).
However, according to the Ministry of Health and Family Welfare, though about 21.17 lakh people (India HIV estimation 2015 report of WHO) are estimated to be living with HIV in India, ART is started only in those patients whose CD4 count is less than 350.
The total number of patients with CD4 count of less than 350 in the country is estimated to be 13,45,678. Of this, the number of people on ART is 9.40 lakh,
making a coverage rate of 70 per cent.
“It is possible that when this policy was formulated, we did not have enough treatment centres. ART may also have side-effects, so that could be another factor why India decided to start ART only for those patients whose CD4 count was less than 350. However, I believe we should comply with WHO guidelines. The reason being that a person diagnosed with HIV, may not have a CD4 count below 350 as he or she has been leading a healthy lifestyle, and that person may not come back for follow-ups at the same hospital. We will also not be able to track the incidence of HIV in the country,” said Aneesha Ahluwalia, a health expert from the city-based Institute of Public Health.
