Centre for AIDS and Related Diseases

Broad outline of activities of the Centre:

• Serological testing and confirmation of HIV infection for referred samples.
• Dried Blood Spot testing for HIV Sentinel Surveillance
• Blinded rechecking of diagnostic and sentinel surveillance HIV testing performed by designated laboratories in Delhi, Haryana, Rajasthan and J&K
• Conduction of External Quality Assessment Scheme (EQAS) for HIV serology  for State Reference Laboratories (SRLs) and their Integrated Counseling & Testing Centres at Delhi, Haryana, Rajasthan and J&K
• Preparation and characterization of panel for HIV/HBV/HCV test kits evaluation
• Evaluation HIV/HBV/HCV test kits referred by NACO
• Absolute CD4 T-Lymphocyte cell count in HIV-positive patients by flow cytometry
• Diagnosis of common opportunistic infections in HIV-positive patients i.e. Cryptosporidium spp. Microsporidium spp. and P. jeroveci in stool and sputum respectively
• Counseling and HIV testing of direct walk-in clients
• Serological diagnosis of syphilis
• HIV/HBV/HCV test kits storage facility to DSACS
• Organization of training programmes for Microbiologists and Technical Staff of SRLs on serological testing for HIV, absolute CD4 T-lymphocyte count by flow cytometry and development of Quality Management System in HIV laboratories
• Support to National Health Programmes e.g. NACO
• Participation in National and International EQAS for:
  • HIV, HBV & HCV Serology
  • Syphilis Serology
  • Absolute CD4 T-Lymphocyte Count

• Centralized sample collection for different Divisions of NCDC
• Support to courses run at NCDC i.e. MPH & FETP

Organogram of the Centre for AIDS & Related Diseases

• Confirmation of HIV infection for samples referred by linked Non-SRL Laboratories 
• Dried Blood Spot testing for HIV Sentinel Surveillance
  • Designated as one of the laboratory for testing of dried blood spot (DBS) samples under HIV Sentinel Surveillance programme of NACO
  • Twenty eight high risk group (HRG) sentinel sites spread across four states namely Jammu & Kashmir, Haryana, Rajasthan & Delhi have been linked to this centre
• Blinded rechecking of diagnostic HIV testing performed by non-SRL laboratories
• Blinded rechecking of sentinel surveillance HIV testing performed by designated laboratories in Delhi, Haryana, Rajasthan and J&K

• HIV/ HBV/ HCV Diagnostic Kits evaluation
  • A consortium of National Reference Laboratories (NRLs) comprising of NCDC, Delhi; NARI, Pune; NICED, Kolkata; NIMHANS, Bangalore and NIB, NOIDA has been formed
  • As part of the consortium activity, the center evaluates diagnostic kits (HIV/HBV/HCV), which are referred by NACO or by the procurement agency hired by NACO
  • Diagnostic kits submitted for evaluation is tested with a panel comprising of 500 well characterized members (100 positive and 400 negative samples)
  • Performance of the kit is evaluated by calculating various test indices
    • Sensitivity
    • Specificity
    • Delta values
• Characterization of panel for kit evaluation
  • Regular collection of blood/ plasma  bags from various blood banks of Delhi
  • Characterized for developing panel for HIV/HBV/HCV kit evaluation
• Conduction of External Quality Assessment Scheme (EQAS) for State Reference Laboratories and their linked Integrated Counseling & Testing Centers
  • 13 State Reference Laboratories (SRLs) in the four states viz. Delhi, Haryana, Rajasthan, Jammu & Kashmir and their associated ICTCs are linked with the National Reference Laboratory (NRL) at NCDC
  • EQAS programme is conducted twice a year for all the 13 SRLs and their associated ICTCs
  • A panel comprising of 08 member for each  of the SRLs and a bulk panel comprising of 04 members for ICTCs is sent after getting validated from NARI, Pune
  • Report of testing conducted on panel by SRLs is compiled and feedback is given to the respective SRLs with a copy to NACO & NARI, Pune
• Blinded rechecking of diagnostic HIV testing performed by linked State Reference Laboratories 
• Confirmation of HIV infection for samples referred by linked State Reference Laboratories 
• Testing of blood-derived pharmaceutical products
  • Blood-derived pharmaceutical products referred by Drug Controller General (India) for testing for infectious markers i.e. HIV, HBV & HCV prior to batch release
  • Tested for various infectious markers (HIV, HBV & HCV)
• Participation in EQAS for HIV serology conducted by the National AIDS Research Institute (NARI), Pune.

• Absolute CD4-T Lymphocyte count in HIV positive patients
  • Laboratory is linked with the Anti-retroviral (ART) centre of Deen Dayal Upadhyay (DDU) Hospital, Delhi and 8 PPTCT centers of Delhi
  • Absolute CD4-T Lymphocyte count is performed on samples received from these sites twice in a week i.e. on Tuesdays and Thursdays by flowcytometry using FACS Count machine
• Participation in External Quality Assessment Programme (EQAS) for CD4/CD3 T-Lymphocyte count conducted by QASI, Canada, in association with National AIDS Research Institute (NARI), Pune

• Diagnosis of Syphilis
  • Samples referred from various hospitals of Delhi for serodiagnosis of syphilis
  • Subjected to Rapid Plasma Reagin (RPR) card test and Treponema pallidum Hemeagglutination (TPHA) test
• Detection of pathogens causing diarrhea in HIV/ AIDS
  • Stools samples are referred from various hospitals of Delhi for detection of opportunistic diarrheal pathogens
  • Subjected to modified ZN staining for detection of Cryptosporidium parvum, Isospora belli and Cyclospora cayetanensis
• Diagnosis of pneumonia due to Pneumocystis jeroveci
  • Respiratory samples (sputum, bronchoalveolar lavage) are subjected to Giemsa and Gomori’s Methanamine Silver staining for diagnosis of pneumonia due to P. jerovec

• The client is counseled and tested for HIV, on his/her own free will or as advised by a treating doctor.
• The main functions include:
  • Early detection of HIV infection.
  • Provision of basic information on modes of transmission and prevention of HIV/AIDS
  • Promoting behavioral change and reducing vulnerability
  • Link people with other HIV prevention, care and treatment services
  • Participation in External Quality Assessment Programme (EQAS) for HIV serology conducted by the linked SRL.

• Clinical samples are collected from the patients for all the divisions of NCDC and then distributed to the respective divisions
• Reports are collected from all the divisions of NCDC and given to respective patients.

• The cold room on the Ground floor of Lab Block acts as the Kit Distribution Unit for DSACS.
• Kits of HIV, HBV and HCV are received and distributed by DSACS to various Centers of Delhi.

• The centre was awarded the certificate of achievement for outstanding performance as a Training Institute by Delhi State AIDS Control Society (DSACS) on 1st November, 2008, on the Occasion of the 11th Foundation Day of DSACS.
• The centre is giving 100% concordant results in various External Quality Assessment Schemes (EQAS) for past many years.
• The National Reference Laboratory at this centre has been identified as one of the five NRLs to be entrusted with the task of HIV/HBV/HCV kit evaluation by National AIDS Control Organization.
• The centre has been designated as one of the laboratory for testing of Dried Blood Spot (DBS) samples under HIV Sentinel Surveillance programme of National AIDS Control Organization.