Experts debate best methods of HIV screening

Experts debate best methods of HIV screening

JAKARTA (JP): In a bid to curb the fast spread of Acquired
Immune Deficiency Syndrome (AIDS), senior local experts are
debating the most effective ways to detect symptoms of the killer
disease, predicted to affect more than 500,000 Indonesians by the
year 2000.

They discussed yesterday how to detect the Human
Immunodeficiency Virus (HIV), which leads to AIDS, and the need
to screen tuberculosis patients for HIV, as well as alternative
screening methods, other than taking blood samples.

Zubairi Djoerban, of the Special Study Group on AIDS at
Jakarta's Cipto Mangunkusumo General Hospital, raised the problem
of treating patients afflicted with both tuberculosis and HIV.

Statistics by the World Health Organization (WHO) shows that
Asians found to have both tuberculosis baccilus and HIV have
increased seven fold in the last decade.

This was revealed by the WHO's tuberculosis program manager,
Arata Kochi, at the 10th international AIDS conference last
August in Yokohama, Japan.

Zubairi said screening tuberculosis patients for HIV would be
useful, given the difficulty of treating people with both
ailments.

"HIV-positive people with tuberculosis are allergic to many
drugs," he said.

In his article in the Peduli magazine, published by the
Special Study Group on AIDS, Zubairi cited cases at the Cipto
Mangunkusumo hospital, in which patients with tuberculosis were
diagnosed as HIV positive only after several months of treatment
for the tuberculosis did not bring results.

"The psychological and economic risks of indiscriminate
screening of tuberculosis patients for HIV are high," he said.

He said WHO has recommended that tuberculosis patients be
further screened if their saliva indicates they have no
antibodies against HIV.

Screening HIV through saliva, and urine samples, was also
scrutinized in the discussion.

Saliva screening has been approved in the United States, where
samples can be taken in the patient's home, but interpretation of
the results can only be conducted at a laboratory, Zubairi said.

As an alternative to taking blood samples, as the first step
in HIV screening, examination of saliva samples is considered
less likely to cause the spread of HIV through the application of
used syringes.

Confirmation tests, with the Enzyme-linked Immunosorbent Assay
(ELISA) and Western Blot techniques, are still necessary to
confirm previous, positive, test results.

Zubairi said America's food and drug administration has listed
the correct procedures for the oral fluid screening, including
that distribution of the necessary kits must only be done by
medical professionals.

Latest estimates on Indonesians with HIV positive and AIDS
still vary.

The figure of 500,000 cases, of people infected with HIV and
having full-blown AIDS by 2000, takes into account various
intervention programs, while research last year revealed that if
such programs were neglected, these cases could reach 2.5 million
in five years.

Meanwhile, Vice President Try Sutrisno underlined yesterday
the need for Indonesia to be vigilant about the spread of the
incurable disease.

"If we are neglectful many more of our citizens will be
affected," he said when opening a creative contest, with the
theme of the prevention of AIDS. (anr)