Health: Bhutan detected at least four new HIV positive cases every month between December 1, 2014 and June this year.

The health ministry reported yesterday that including an 18-month-old child the ministry detected a total of 29 people living with HIV.

Of the total detected, 13 are males and 16 are females, taking the total number of people living with HIV in the country to 432. Since its first detection, Bhutan has detected 217 males and 215 females as HIV positive.

The demographic characteristics of the new cases show that a majority of the infected are married and are in the reproductive age group of 20-49 years.  It was found that the CD 4 count for males above 30 years of age was much lower than that of females between 20-29 years.  Of the total detected, 10 percent are below 19 years while seven percent constitute parent to child transmission cases.

“Therefore, it is more likely that younger females are being infected more recently than elderly men,” the health ministry’s press release states.

CD4 count indicates how well a person’s immune system is working. The CD4 cells or T-cells, health officials explain are a type of white blood cells that play a major role in protecting the body from infection.

The CD4 count of a healthy adult/adolescent ranges from 500 cells/mm3 to 1,000 cells/mm3.

Based on their CD 4 count, 15 of them, eight males and seven females are eligible for treatment. As per the National treatment guideline, an HIV positive client will be eligible for treatment if his/her CD 4 count is less than or equal to 500 cells/mm.

Today, the health ministry has put 13 of them on Anti-retroviral (ART) treatment while the remaining two will begin their treatment next month.

While tests for the 10 HIV positives are still underway, the ministry found that out of 19 tested for CD4 count, eight had a CD4 count above 400 cells/mm3, indicating recent infection.

“However, 11 of them whose CD4 count between 300-400 cells/mm3 might have acquired the infection three to seven years ago and many of them are in clinical latency stage while two of them have progressed to AIDS stage,” the press release states.

The press release states that the health ministry is re-strategising its approach to intensify case finding through micro-stratification of population, identifying the most at risk population and by doing a comprehensive risk assessment of individuals.

“Although there seems a progressive increase in the number of cases every year, Bhutan still has a case detection gap of 60.7 percent to reach the 2013 UNAIDS estimation of 1,100 cases,” the press release states.

Meanwhile, of the total detected, nine were detected through the voluntary counselling and testing services, another nine through medical screening, seven through contact tracing, two through active surveillance and one through mother to child transmission (MTCT).

The dominant mode of HIV transmission, in 90 percent of cases, was through the sexual route followed by MTCT in seven percent of cases.

Since 2006, the health ministry reported that at least 25 cases have been detected every year and in the last three years, the average yearly detection has been 42 cases.

“Of the total reported cases, approximately 75 percent were reported from 2004 onwards, which is attributable to the consistent and continuous effort of the government and its partners,” the ministry reported.

By Sonam Pelden