I am a paediatrician in Uganda 3rd world setting I have a child I am attending too whose CD4 count has failed to pick up despite ART with good adherence she has clinically responded to the ARVs. What to do

A Day 15 old girl born to HIV infected parents came for first follow up visit. Mother was diagnosed to be HIV infected at 6 moths of gestation and had received Zidovudine for 3 months. Baby was born vaginally and not on breast feeds. Birth weight of the child was 3 kg. Baby was started on Zidovudine 2 mgkg dose 6 hoy and was advised to give 0.6 ml qds of Zidovudine syrup 5 ml = 50 mg every 6 hoy. However, on interviewing the mother, it was found that she was giving the baby 6 ml 6 hoy instead of 0.6 ml 6 hoy. However, the baby had no other symptoms. On examination, her weight was 3.5 kg and examination findings were normal.

P, is a 7 year old girl whose parents were HIV infected. She underwent HIV testing at Mumbai in a government setup. Her tests revealed that she was also HIV infected. Her parents were devastated. P had never had any problems in her life and was an outstanding student in her school. Parents contemplated suicide but decided to do another test after consulting another doctor. Fortunately for P, her test was negative. Subsequently her tests have come negative elsewhere too. P is not HIV infected. Why did P get a positive HIV report There have been many newspaper articles on faulty kits and false positive HIV reports. Infact due to not knowing identity of these patients, many patients who may have tested positive may actually be negative and not knowing about the same. What life they must be living!!. It may be miserable for them. Not all like P would have got a repeat test done elsewhere. Someone may have contemplated suicide, some one may have got depression and someone may have even lost his senses. Who stands responsible - the government who did the test, the manufacturer who made the kit, the agency who selected the kit Someone has to be responsible and avoid such irrational behaviors. HIV is not a disease to be taken lightly - imaging the plight of knowing a positive result. The mental and social trauma is too large, there is too much at stake. Such substandard kits should be banned, corrective action should be taken and the government should wake up. Its high time, people demand their rights.