HIV infection rates among persons attending an ICTC of a Delhi hospital.

Sir,

Human immunodeficiency virus (HIV) infections are being reported the world over with over 33 million affected and estimated 2.5 million people in India at the end of 2006.[1] National AIDS control program was launched in the 1990s with the aim to reduce HIV infection rates. The program envisaged integrated counseling and testing centers (ICTC) as a key component of an effective primary prevention, treatment and care of HIV-infected persons.

We report the infection rate among persons reporting to ICTC of a North West Delhi hospital from 1 January 2007 to 31 December 2008. All persons reporting (excluding pregnant females) were provided pre- and post-test counseling, which included awareness about drug abuse, safe sexual practices, blood transfusion, HIV and its spread etc. Only those giving written consent were subjected to HIV (1 and 2) antibody testing using rapid kits, and declared reactive as per National AIDS control organization (NACO) guidelines strategy III.[2] External quality assurance program was rigorously adhered to with the regional state reference laboratory. The infected persons were referred to antiretroviral therapy center of our hospital.

Out of a total of 10809 serum samples tested, 579 (5.3%) were positive for HIV antibody and 453 (78.3%) [Table 1] out of them being direct walk-in. Maximum seropositivity 234/579 (40.4%) was found in 25–39 year age group and male : female ratio was 1.93 : 1. The route of transmission was heterosexual in 518 (89.4%) cases.

Table 1

HIV infection rates 2007 and 2008

In our study, the HIV infection rates are lower than NACO rates, which have an average all India seropositivity of 9.6% among total ICTC clients and Sawaithul et al. who report 31.2% seropositivity among their clients.[34] In comparison to overall Delhi rate of 4.2%,[1] seropositivity in our areas is more, which could be due to good AIDS awareness among our clients and/or due to large migrant population especially truck drivers in the area catered by our hospital.

In conclusion, we emphasize the importance of ICTC as an integral point connecting the HIV-infected person to counseling and further treatment. The data generated at ICTC can be an important indicator to the prevalence of HIV infection in the given region in the absence of large population-based surveys. The large number of cases in reproductive (25–39 years) age group is a cause of great concern. Heterosexual contact remains the major cause of spread of HIV in our area.