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)