Health Check: RHIVDA

FOLLOWING the efforts of several groups, such as the Kagay-an Plus Inc. and the Oro Youth Development Council, in their campaign for HIV (human immunodeficiency virus) awareness, the number of people willing to be tested has increased which also resulted to the rise of persons diagnosed with HIV.

Diagnosis of HIV is very important as it is a requirement in order to initiate treatment as medicines will not be given if you do not have confirmed results, according to doctor Neal Rana, specialist on Occupational Medicine and Pathology and the chairman of the Office of Documents and Records Control of Northern Mindanao Medical Center (NMMC).

Confirmatory testing

in the Philippines started in 2001. When a person tested "reactive" in the screening test, the specimen is sent to the National Reference Laboratory in Manila, wherein the Western Blot Test is performed for confirmation.

"From year 2001 to 2008, the confirmatory center runs HIV confirmatory testing twice a month with an average of less than 50 confirmed cases per month," Rana said.

"It then grew up significantly until in year 2015, we have an average of 655 national confirmed cases per month, climbing to 708 in 2016, 800+ in 2017, and reaching up to 1200 {by the end of} year 2017," he added.

As years went by, there is a significant increase in the number of HIV cases that warrants immediate treatment.

Rana said it usually takes 10 days to two weeks for the release of the confirmatory result, however, nowadays, it will take one to two months which is too long especially those patients who are already suffering AIDS (acquired immunodeficiency syndrome) complications.

"Baka pagbalik ng result, patay na sila or hindi mo na makita kung saan na sila. Isa lang po ang ating confirmatory center (maybe when the results come back, you may no longer see them because they might already be dead, or nowhere to be found. We only have one confirmatory center)," Rana said.

The confirmatory center in Manila has already made adjustments from the twice monthly running of test aside to daily in order to cope up with the growing demand, he added.

“Still, at times, matagalan pa rin ang (it will take time for the) result since aside from following the standard testing algorithm, meron pang ibang (there are other) factors like packaging, handling and transport of specimen and subsequent results,” Rana said.

In order to address the current problem in confirmatory testing, the Department of Health (DOH) has adopted a new approach called “rHIVda” or the Rapid HIV Diagnostic Algorithm.

The rHIVda uses a combination of three rapid test formats done in sequence on a sample that had a reactive result in the initial test.

“Meaning the confirmatory testing is done sa screening center mismo (in itself). Hindi na natin ipapadala sa (we will no longer send it to) Manila and wait for weeks for the result,” Rana said.

Through rHIVda, the waiting time for confirmatory results will shorten thus, persons who are diagnosed and confirmed with HIV will immediately be treated.

At present, the pilot implementation of rHIVda is only in Manila, Cebu and Davao. However, the NMMC already have the necessary equipment given by the DOH.

“For those who are not included in the pilot areas, including us, our target to start rHIVda is within this year. Probably mid or later part [of the year]. Trained na rin yung personnel natin (the personnel are also trained),” Rana said.

He added that the DOH plans to implement rHIVda to all treatment hubs including 19 local government units on the first year, in which Northern Mindanao is included.

“In the second year, lahat ng LGUs (local government units) and regional hospitals and in the third year, all private testing centers pwede na rin silang mag (they can) apply for testing,” Rana said.

From January to February 2019, the NMMC has recorded 157 patients tested for HIV and according to Rana 46 of them are reactive.

“We are aware of the implications of the current process and together with DOH (Department of Health) and guided by the World Health Organization, we are continuously improving our capabilities to cope up with the current demand. Sana (hopefully) we can implement it as soon as possible with the go signal of DOH. We are all for good health and better treatment outcomes,” Rana said.