Central Govt to provide free Viral Load Test Scheme for All People Living with HIV / AIDS (PLHIV)

Published Date - 28 February 2018 03:36:46 Updated Date - 28 February 2018 03:38:31

The government on Monday launched a scheme to provide free of cost viral load testing, at least once a year, for 1.2 million people who are living with HIV/AIDS (PLHIV) and are on treatment.

The viral load is used to monitor the effectiveness of Antiretroviral Therapy (ART) over time. It measures the amount of HIV genetic material (RNA) in the blood and reports how many copies of the virus are present.

Health minister J.P. Nadda, while launching the initiative in New Delhi, said that with the initiative the government will monitor the effectiveness of treatment of patients on lifelong ART treatment.

“The routine viral load testing will optimize the utilization of first line regimens, thus preventing drug resistance and ensuring the longevity of people living with HIV. Viral load testing will empower medical officers at ART to detect failure on first line treatment early and therefore save PLHIV from developing resistance to drugs. It will also help in strengthening ‘Mission Sampark’ in tracking LFU (loss to follow up) PLHIV and to be brought under ART services,” said Nadda.

In 2017, India revised the ART treatment protocols to initiate all PLHIV on ART. The ‘treat all’ initiative was started to ensure that treatment is started early and the virus transmission is curtailed both at the individual and the community level.

According to the union health ministry, about 1.2 million PLHIV are availing the benefit of free treatment from more than 530 ART centres.

Nadda also released the National Guidelines for HIV-1 Viral Load Laboratory Testing, National Operational Guidelines for Viral Load Testing, Standard Operating Procedure for HIV-1 Quant Assay with Cartridge-based nucleic acid amplification test (CBNAAT) (to diagnose tuberculosis and rifampicin (TB drug) resistance) and Guidelines on Quality Monitoring System for Outsourced Viral Load Tests.

“With launch of Test and Treat, there is increase in number of PLHIV needing treatment and thus the Viral Load testing. With increase in number of PLHIV on treatment the monitoring needs have also increased,” said Anupriya Patel, minister of state for health and family welfare.

India has the third largest population of people with HIV after South Africa and Nigeria, according to UNAIDS. The report released n July 2017 revealed that in India, only 49% of patients were on Antiretroviral therapy (ART) in 2016. India had 2.1 million people living with HIV at the end of 2016 and 36.7 million globally, according to the report.

Viral Load Testing is the next important step for treatment and monitoring of people living with HIV after “Treat For All” initiative. This Viral Load Test is of paramount importance for measuring the effectiveness of treatment taking lifelong Antiretroviral Therapy.

Moreover, this Viral Load Testing Scheme will empower ART medical officers to track failure on 1st line treatment and will thus sava PLHIV to develop any resistance towards drugs.


Launch details                                                

The new scheme for implementation will be launched by the Health Ministry and central government. The official announcement for launch was made by J.P. Nadda, Health Minister on 26th February 2018. The new initiative was announced by the HM in New Delhi.

Key features

  • The government has announced the new initiative for implementation for the HIV and AIDS patients who are already undergoing their treatment. Using the new testing system the effectiveness of ART (Anti-retroviral Therapy) can be monitored by the health care services over a period of time.
  • The new system has been designed to measure the patients RNA for HIV Genetic material in the patients blood and a report will be generated related to the Virus count present in the patients blood.
  • The system can be used by the patients for life long monitoring for the effectiveness of the ART treatment undergoing. Apart from this the testing system will also help in deciding the selection of right dosage level for treatment for the patients to help ensure the longevity for AIDS / HIV patients.
  • It will also prove helpful in preventing side effects of the drugs taken by the patients in the long run. In case any failures of the detection for patients at the time of first line treatment the system will help detect the failure by the medical officers so the resistance to drugs can be prevented in the initial stage itself.
  • The system will also help in prevent Loss of follow up by the medical services under ART and PLHIV by promoting better interaction with patients under Mission Sampark.
  • The main aim of ART under PLHIV is to help identify the patients for treatment at an early stage of detection of HIV / AIDS symptoms. This will also ensure that the patients can receive treatment at the right time such that the spread of the virus amongst the community can be prevented.
  • The government has also stated that for better implementation of the system the government will set up over 530 ART centers nation wide. The Viral load test will be outsourced by the government under stated guidelines for Laboratory testing, Viral load testing, Drug resistance testing, quality Monitoring, CBNAAT (Cartridge Based Nucleic acid amplification test) and Operating procedure for HIV-1.
  • As per the statements collected by the sources, there has been an increase in the number of patients using the PLHIV treatments and so there in also a need for offering increased monitoring systems.

According to the latest stats, over 49 percent of patients are already receiving ART which is the largest number right after Nigeria and South Africa. By the 2016 it is expected that over 2.1 million people nationwide will be benefited by the ART.

Viral Load Test Scheme

This routine Viral Load Testing will optimize utilization of first line regimens. Accordingly, this will prevent drug resistance and thus ensure longevity of people suffering from HIV. Viral Load Test Scheme will also strengthen “Mission Sampark” to monitor ‘Loss to Follow Up (LFU) PLHIV. Viral Load Testing will also reduce the disgrace and discrimination of PLHIV and provide them with proper access to health services.

At the official launch event, Health Minister has also released National Guidelines for HIV-1 Viral Load Laboratory Testing, National Operational Guidelines for Viral Load Testing, Standard Operating Procedure for HIV-1 Quant Assay with CBNAAT and Guidelines on Quality Monitoring System for Outsourced Viral Load Tests.


Central govt. has also passed HIV / AIDS Act – law for protection of rights of HIV affected people. THe important features are listed in the table below:-

Prohibition of discrimination

Informed Consent

Non-disclosure of HIV status

Anti Retroviral Therapy (ART)

Opportunistic infection management

Protection of property of affected children

Safe working environment

Appointment of ombudsman in every State

Treat All Initiative

In the FY 2017, Central govt. also started “Treat All” initiative to ensure early treatment and stopping virus transmission. Accordingly, Indian govt. also revised the Antiretroviral Therapy (ART) treatment protocols. This Treat All initiative prevents virus transmission at both the individual and community level. Henceforth, around 12 lakh PLHIV are availing the benefits of free treatment at approx. 530 ART centers.

For the past few years, there is an increase in the number of PLHIV who requires proper treatment and thus there is an increase in the monitoring needs. Henceforth to monitor viral load suppression, NACO scales up the Viral Load Testing facility.




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