Medical Problems in tackling LFUs of ART

June 2, 2009

Dear forum,

We understand and every one of us experiencing immense difficulties in tackling

PLHIVs on loss of follow-ups(LFU)

Tracing their addresses,approaching their residences,bringing them out for

follow up, treatment, and ART registration everything will be difficult of

course.

More than that, I feel that we don't have adequate giudelines to continue the

drop-outs of treatment especially who are on Anti TB drugs or more important

those who are already started on ART at a Govt ART Center.

I feel the following are the reasons for LFUs:

1. Fear of reaveling ART status

2. ART intolerance

3. ART toxicities

4. Not able to access the Govt ART center ( health,poverty, lack of time, not

able to travel, depression)

5. Insult received at ART center,

6. Shuutling the patient here and there etc.

Inspite of all these, if we able to pacify and bring the case for treament.

We don,t have the facility to see the drug sensitivity pattern for ARV drugs, or

ATT drugs.

We have to go by only with few options of like SLN, ZLN, SLE OR ZLE.

Once when we started a combination and the patient became a drop out there is

every chance for them to aquire a resistence for Lamividine and NNRTIs and

possibly also to Thymidine analogue. Then there will not be much use to start

another combination within the four combinations available at a Govt ART center.

More over most of the time when we trace them to Govt ART center they were made

to wait for another consideble period, say 15 days to 45 days, to verify their

interest to have treatment and also their adherenvce to treatment capacity.

During that period their health, immune system got worsen further, so that even

if they restarted treament they will not respond to treatment.

Sometimes even we may likely to loose the patient's life during the compulsory

waiting period.

We have to find solutios to all these puzzles as early as possible to save

hundreds of lives of PLHIVs.

Dr S.Murugan

Sr Consultant in HIV Medicine,Shifa hospitals,

Chief medical officer

PEACE COMMUNITY CARE Center

Tirunelveli, Tamilnadu

<muruganyes@...>

Recommended Posts