For months now, HIV patients at Patna Medical College and Hospital are being prescribed medicines blindly, without the mandatory Cluster of Differentiation 4 (CD4) test, because of absent testing kits.

Doctors admit this can be dangerous. HIV patients should be prescribed drugs only after checking their immune system. So, they need to undergo CD4 tests regularly. CD4 cells are white blood cells that fight infection. As HIV infection progresses, CD4 count drops. When it falls below 350, a person is diagnosed with AIDS.

A normal CD4 range is 600-1,500. When a person with low CD4 count starts taking the prescribed drugs, CD4 count rises and the virus is controlled.

All ART (antiretroviral therapy) centres provide CD4 test for free to patients while private labs charge Rs 2,000-3,000. So, getting a CD4 test is not easy for poor patients. When The Telegraph visited the ART centre at Patna Medical College and Hospital (PMCH) on Saturday, it found CD4 test kits were not available. An official denied it, but when pointed out that several patients had said so, he said: “Whatever the situation, higher officials are aware of it. Check with them.”

“I was here for my CD4 test a week ago. Then, too, the kit was not available. For an HIV patient, it is very important to get CD4 test done every 2-3 months as drugs can be prescribed on the basis of the test only,” said Ramesh Ram (42) from Hajipur.

Renu Devi of Patna came on Saturday for her CD4 test but was disappointed.

Dr Diwakar Tejaswi, an AIDS specialist and member, governing body, Bihar State Aids Control Society, said CD4 test was important.

“Many times some drugs don’t suit a particular patient. Only a CD4 test will show if a patients’ body is showing resistance.”

A senior doctor at PMCH accepted that they were blindly treating patients. “Now that the test is not available, we are treating them without CD4 test report. This can be dangerous.”

Another doctor said: “New patients who come to the ART centre are the worst sufferers. Consider a patient newly diagnosed with HIV at PMCH and referred to the ART centre for CD4 test. Until the test is done, medicines cannot be prescribed as ART centre provides the medicines only if CD4 count is below 350. Old patients already on medicines can still be given some medicines, though that too is not safe.”

PMCH superintendent Amar Kant Jha Amar said: “The ART centre is short of CD4 test kits for the last six months. PMCH had got 5,000 kits from Naco headquarters two years ago but those were defective. Later we got 2,000 kits on loan from Gaya but the stock got exhausted six months ago. I have informed the Naco headquarters in New Delhi. They are going to send us 1,000 kits soon.”

(Names of patients changed to protect identity)