Laboratories failed to cope with the viral load
[ad_1]
Russians with HIV again complain to the public movement “Patient Control” about the inability to conduct blood tests to assess the effectiveness of therapy. In 2020, AIDS centers explained refusals to take tests due to the workload of laboratories with tests for COVID-19, now – sanctions and the rise in the cost of reagents. In St. Petersburg, they even intend to check the viral load and immunity once a year, with the recommendation of the Ministry of Health of the Russian Federation at least twice a year. Vadim Pokrovsky, head of the federal AIDS Center, calls this problem “chronic” and explains it by inconsistency between the Ministry of Health of the Russian Federation and the regions. The Ministry of Health says that “the current availability of tests for diagnosing HIV remains high.”
In a number of regions of the Russian Federation, patients with HIV cannot undergo blood tests for viral load and immune status for several months, Yulia Vereshchagin, a representative of the Patient Control public movement, told Kommersant. Especially many complaints about refusals come from the Chelyabinsk and Kemerovo regions. Problems have also been identified in the Ulyanovsk, Kaliningrad, Orenburg, Arkhangelsk, Kurgan, Nizhny Novgorod, Tyumen, Amur, Leningrad, Moscow, Novosibirsk, Oryol regions, the republics of Crimea, Kabardino-Balkaria, North Ossetia, Dagestan, Krasnodar and Krasnoyarsk territories and St. Petersburg. Ms. Vereshchagina noted that, according to the recommendations of the Ministry of Health, new patients should be examined once a month, then, while the condition is stabilizing, once every three months, and then once every six months. People with HIV who have not checked their indicators for more than a year turn to Patient Control.
Yulia Vereshchagina spoke about a resident of Chelyabinsk, who came to the regional AIDS center at the end of April to find out the results of tests taken back in January 2022. “They said they didn’t do it, because there are no test systems. Allegedly, they are imported, and due to the current situation with Ukraine, they are not. I have a low immune status, and it is important for me to know if everything is good in my body, ”the woman said. She added that reagents have not been available in the Chelyabinsk AIDS Center for more than a year, and “they blame it either on the coronavirus or now on sanctions.” Note that in November 2020, Kommersant said that the impossibility of doing these tests for HIV patients in the regions was explained by the workload of laboratories testing citizens for COVID-19.
A patient from Chelyabinsk was going to go for an appointment in June, however, according to Ms. Vereshchagina, the situation in the region had not changed by August, and complaints from citizens with HIV continue to come in. Regional authorities ignore requests from Patient Control. Kommersant also failed to get a comment from the Chelyabinsk Ministry of Health at the time of publication.
Olga Borodkina, deputy chief physician for the medical part of the Kuzbass Center for the Prevention and Control of AIDS, told Kommersant that “at the moment there are no problems with conducting the necessary tests” in the center. Note that the last complaint from a resident of the region “Patient Control” received on July 27. At the same time, Mrs. Borodkina acknowledged that when the geopolitical situation changed, some problems arose with the timing of reagent supplies. In March, according to her, it was not even possible to hold one of the auctions, but then all the purchases were made. “The only thing that has changed a lot is the length of delivery times — from 10-20 days to 90-120,” she said. In such circumstances, it was necessary to carry out a “medical sorting”: only children, pregnant women, patients with indications were tested, and planned tests (three during the year) were shifted in time to a later date.
A similar situation probably developed in the Kaliningrad region. The local Ministry of Health has not yet commented on the complaints received by the organization up to the beginning of August to Patient Control. However, the problem is confirmed by announcements from the administration of the Kaliningrad AIDS Center, posted, according to patients, on the doors of offices. It states that “due to the delay in the delivery of test systems for determining the immune status from a foreign manufacturer, the research is postponed until the diagnosticum is received.”
An infectious disease specialist announced to a patient from St. Petersburg that now they would take tests once a year, “because of the sanctions, reagents have become expensive.” Indirectly, this complaint is confirmed by a video published on the page of the AIDS Center of St. Petersburg on VKontakte with the title “HIV under control”. “We are inclined to believe that if the patient carefully takes therapy, then we can look at the tests once a year,” Natalia Sizova, deputy head physician for outpatient clinical work, addresses patients.
Vadim Pokrovsky, head of the federal AIDS Center, disagrees with this interpretation. He notes that usually tests for viral load and immune status are done three to four times a year. Without such control, a person may not know that his treatment is ineffective: “He even seems to be receiving therapy, but, say, the drugs are unsuccessfully selected, and he has, say, a virus resistant to these drugs. He does not see deterioration, they are hidden, but in the meantime, immunity is falling, the amount of virus in the blood is increasing, and sooner or later this will give clinical manifestations.
The only region whose authorities not only responded to the request of Patient Control, but also recognized the problem is the Ulyanovsk Region. Difficulties with changes in immunity and viral load indicators in patients with HIV in the regional department were explained by a decrease in federal funding for the purchase of test systems by 2,050,400 rubles in 2022. compared to 2021. At the same time, the Ministry of Health assured that they allocated more funds from the regional budget and promised to provide patients with test systems by the end of May this year. According to Yulia Vereshchagina, just on May 27, the last complaint came from the region: probably, after that the situation really improved.
Vadim Pokrovsky calls interruptions in providing patients in Russia with tests for viral load and immunity a “chronic disease” that occurs from time to time in almost every region. This is due, in the opinion of Mr. Pokrovsky, “to the disparity in financing.” Part of the funds for the purchase of these tests are sent to the regions from the federal budget, the rest must be allocated by the subjects themselves. “In this regard, apparently, there is not enough purchase. It’s hard to say who is to blame, but there is no consistency,” says Vadim Pokrovsky. He emphasizes that in Russia, on the whole, there is now an “insufficiently centralized” fight against HIV infection: “If earlier there was a clear vertical: the federal center, district centers, which more or less controlled this situation, now there is the Ministry of Health and there are regions whose actions are not entirely consistent.”
In response to Kommersant’s request, the Ministry of Health of the Russian Federation provided a comment by the chief freelance specialist on HIV infection, Alexei Mazus, on the terms of its publication without abbreviations: “Tests for diagnosing HIV are a sensitive area of Russian healthcare. But not in the meaning that non-profit organizations are trying to attach to this, which have been receiving grants from influential organizations unfriendly to Russia for decades and using this money to express active resistance to the successes of Russian healthcare (as a rule, through its media “weakening” and giving additional weight in the public field to the technical details of the organizational processes, which in fact do not fundamentally affect the availability of diagnostics for patients). And just in the sense of an unrelenting focus both on the part of the Ministry of Health of the Russian Federation and on the part of the territorial executive authorities of the constituent entities of the country (purchasing HIV diagnostics is primarily their area of responsibility).
This does not and cannot, as in any industry, exclude logistical failures in individual regions. However, the current availability of HIV diagnostic tests in Russia remains high. In addition, my colleagues and I have repeatedly announced that the state import substitution program has been updated on this track, which has been implemented in the country for more than a year. To a decisive extent, the lines of tests for diagnosing HIV have been replaced with the corresponding Russian-made systems.”
[ad_2]
Source link
