MUMBAI: A laboratory from the eastern suburbs will be at the centre of the Union health ministry’s mission to bring about a path-breaking shift in HIV care as it sets out to test viral loads of over 1.2 million positive patients over the next three years.Viral load testing, which has long become the gold standard to monitor HIV treatment and disease progression the world over, will now be offered free of cost at 525 anti-retroviral centres across the country, including 84 from the state, by the National Aids Control Organisation (NACO). Previously, the test used to be offered to 20,000 people following a tedious process of selection stretching into months. Several long-term HIV patients could not afford the test as it costs Rs 7,000 in private labs.This February, NACO entered into a public-private partnership with Metropolis Healthcare. Under the arrangement, samples from Jammu & Kashmir to southern India and north-eastern states will be flown to the city and tested at the lab’s Vidyavihar facility. In the first year, two lakh samples will be tested, which would be doubled in the second year and tripled in the third to cover all 1.2 million Indians living on antiretroviral treatment ( ART ).Initially, all ART centres from Mumbai will be extended the service, though there will be prioritizing of patients. It will be scaled up subsequently to include more ART centres as the collection and transportation of samples is streamlined.“Our programme has so far relied on the CD4 (immunity) count, which essentially tells us how much damage the virus has caused already. We need the viral load testing to see if a regimen is effective, and promptly shift a patient to the second or third line therapy if it’s not,” said Dr Naresh Goel, deputy director general of NACO. He added the tests will be carried out at a cumulative cost of Rs 150 crore. Dr Nilesh Shah, president of Metropolis, said samples would be flown in a temperature-controlled environment for quality and to prevent any mishaps. “Even those from remotest parts should reach city under 48 hours,” he said, adding that reports be emailed to respective centres. BMC’s executive health officer Dr Padmaja Keskar said patients who are failing the first line therapy, pregnant women and lactating mothers will be given priority. “Once someone is detected with a high viral load, the case will be referred to Byculla’s J J Hospital for treatment,” she said. The city has around 37,000 people on ART. Ganesh Acharya, who has lived with HIV for two decades, welcomed the facility but added that NACO should make it routinely available.