One-sixth of HIV/AIDS patients in public health system
Marked increase in persons volunteering to be tested - Ramsammy

Kaieteur News
February 2, 2007

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About 3,000 of the 18 to 20,000 Guyanese living with HIV/AIDS (approximately one-sixth), are being monitored by the local public health system.

Approximately 1,100 of these have been initiated into the Anti Retroviral treatment program at various health institutions throughout the country.

The Genito-Urinary Medicine (GUM) Clinic treats about 600 of these patients, the Linden Hospital (40), Suddie Hospital (60), New Amsterdam (60) and the St. Joseph Mercy Hospital , another 60.

However these figures may not accurately reflect the true status of the disease locally since it does not include statistics from the private health institutions.

Health Minister Dr. Leslie Ramsammy says the figures are slow in coming from these institutions.

He however believes that the majority of persons utilize the public health institutions for testing, counseling and treatment of the disease.

There is also a marked increase in the number of persons volunteering to be tested for HIV/AIDS according to the minister.

“The treatment programme at the GUM clinic tells the whole story. Compared to 2002-2003 when, 2-3 persons were initiated into the ARV treatment programme, we are now seeing about 35 persons initiated every month.”

In addition to regular counseling, these patients are continually monitored to ensure that their CD4 blood count remains at an acceptable level.

This is now possible with the acquisition of a CD4 machine by the health sector.

Prior to this, patients were put on Anti Retro Viral treatment when they became symptomatic with one of the opportunistic infections of the disease

The CD4 count indicates the strength of the immune system, how far HIV disease has advanced (the stage of the disease), and helps predict the risk of complications and debilitating infections. The CD4 count is most useful when it is compared with the count obtained from an earlier test.

The CD4 count is used in combination with the viral load test, which measures the level of HIV in the blood, to determine the staging and outlook of the disease.

“Once a patient's CD4 count is below 200, they enter treatment. For a pregnant woman that yardstick is below 250.” the minister said.

According to public health guidelines, preventive therapy should be started when an HIV-positive person who has no symptoms registers a CD4 count under 200.

Some physicians will opt to consider treatment earlier, at 350. The Centers for Disease Control and Prevention considers HIV-infected persons who have CD4 counts below 200 to have AIDS, regardless of whether they are sick or well.

Normal CD4 counts in adults range from 500 to 1,500 cells per cubic millimetre of blood.

Minister Ramsammy related that the ARV treatment locally has seen reasonable success, noting that Guyana was fortunate to produce its own anti retrovirals.

The New GPC produces about 13 types of anti retrovirals locally.

He noted that once the treatment is administered, a patient's CD4 count returns to normal allowing them to live long, healthy lives.