The Hindu : Claim on HIV negative status for child contested

Online edition of India's National Newspaper
Monday, Apr 07, 2003

Southern States

Southern States - Kerala

Claim on HIV negative status for child contested

By Our Staff Reporter

KOTTAYAM April 6. The Kerala State AIDS Control Society has taken serious exception to the claim being made by the Bishop Mar Joseph Kundukulam (BMJK) AIDS Research and Rehabilitation Centre at Peringadur in Thrissur district that one of their wards, who was found HIV positive at birth was found HIV negative after he had turned one-and-a-half years old as a `rare case of medical history'.

Speaking to The Hindu here today, R. Sajith Kumar, State PRAM (Physician Responsible for AIDS Management) said this has been accepted as a natural phenomenon and 70 per cent of the children born to HIV positive mothers pass through this phase. ``The child probably was never HIV infected nor has anything that happened in between his birth and now anything to do with the change in the results of the tests conducted'', he said.

Ninety-nine per cent of the children born to HIV positive mothers would be found HIV positive at birth, in Elisa and Western Blot Tests, he said.

``This is because at birth, anti-bodies from the mother is transferred to the child through a process which, in medical terms is called `transplacental transfer of immunoglobulins. These antibodies would start disappearing once the child develops its own antibodies. The period for developing own antibodies may take up to one-and-a-half years. Since Elisa and Western Blot Tests look for the presence of specific antibodies to declare the patient HIV positive, children below the age of one year born to HIV positive mothers would also be found HIV positive, he said.

Only the virus load test or PCR (Polymerised Chain Reaction) hunts for AIDS virus. As such if found positive in this test, is almost certain that the patient is HIV positive. However, the major disadvantage of this test is that it is not only costly but a negative result proves nothing- just because you have been found negative in the PCR you cannot be sure that you are NOT infected'' he pointed out.

``In fact, there is a standing rule that children below the age of one year should not be tested for HIV,'' Dr. Kumar said. Citing an example from his personal experience, Dr. Kumar said a child born to one of his female patients, was found HIV positive when the parents tested the baby when it was one week old. They had done this against the advice of the doctor. However, the child is now four years old and is HIV negative. This was only a natural phenomenon, he said. There are so many cases like this, he added.

Referring to the chances of `false positive results' in the tests, Dr. Kumar pointed out that the incidence of false positiveness is as high as 65 per cent. ``There are several conditions that lead to a HIV positive result and presence of AIDS virus is only one of them. Under Indian context these other conditions (conditions other than presence of AIDS virus) are more. Hence the large percentage of false positive results'', he said.

The Society has also pointed to the moral issues involved in publicising the `non-issue', possibly with a commercial angle at the cost of the privacy of an orphan child, especially at a time when the stigma against AIDS victims in Kerala's middle class mores is on the rise. The experience of the Chathannur children are still in memory. By misleading the public, in this manner, the future of this orphan child has been put under stigma, that too for no fault of the child or the profession, he pointed out.

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Claim on HIV negative status for child contested