In HIV Case, Key Evidence Trails Behind Guilty Verdict

When the Battambang Provincial Court last week handed down a 25-year prison sentence to Yem Chrin, an unlicensed medic blamed for spreading HIV to more than 280 residents of rural Roka commune, it likely failed to consider relevant medical evidence, according to interviews with doctors and health officials.

The court also went forward with the guilty verdict despite not having the results of the genetic testing currently being done at the Institut Pasteur in Phnom Penh, which has the potential to shed light on the origins of the HIV epidemic in Roka and is due to be completed within weeks.

While prosecutors relied heavily on the testimonies of nearly 90 infected villagers during Mr. Chrin’s five-day trial in October, the court said on the final day of the trial that it would also seek the results of testing being conducted by the Institut Pasteur, which has been actively studying the HIV that was first detected in Roka in December last year.

It is unclear precisely which tests the court was referring to. According to Institut Pasteur director Didier Fontenille, the testing being conducted by his institute has focused on three separate areas: blood samples from Roka villagers, syringes and rubber tubing seized from Mr. Chrin’s house by investigators in December, and the genetic makeup of the HIV in the commune.

While the blood samples were tested shortly after the outbreak was detected in order to confirm the infections, further tests to examine whether HIV and antibodies were present on Mr. Chrin’s medical equipment were only completed recently.

Dr. Fontenille said researchers at the institute had not yet completed the “important” genetic sequencing of the HIV in Roka, which would determine the genetic source and possible origins of the virus.

“What we want to know is if there is a high diversity of viruses in Roka or if almost all the viruses are almost the same, which means having an almost unique source,” he said, adding that preliminary results showed little genetic diversity.

“We know it is almost one unique source, but what we do not understand yet is if it is only one practitioner, several practitioners or several practitioners plus sexual transmissions and drug use,” Dr. Fontenille said.

“We expect to finish the sequencing and analyses in the next weeks, or at least [in] one or two months,” he added.

Dr. Fontenille said he forwarded a report of his team’s findings on Mr. Chrin’s medical equipment to the Ministry of Health last month, but that he was unsure if the document ever made its way to the Battambang court.

“The Ministry of Health got the results. I do not know if these results have been presented at the court or not,” Dr. Fontenille said. “We have not been invited to go [to the court].”

He added that the findings—which he declined to disclose—had been sent to his “only contact” at the Health Ministry: Mean Chhi Vun, the former director of the National Center for HIV/AIDS, Dermatology and STD (NCHADS), who retired in February, but remains an adviser at the ministry.

Dr. Fontenille said that Dr. Chhi Vun and others at NCHADS were all appraised of the Institut Pasteur’s findings on the medical equipment, as well as its ongoing effort to sequence the virus’ DNA.

“He knows that very well because we had several meetings,” he said. “We have regular meetings, and the new director of NCHADS also participates in all these meetings.”

However, asked on Monday whether he had passed on the information from the Institut Pasteur to the court, Dr. Chhi Vun refused to provide a clear answer.

“I did not receive the official report from the Institut Pasteur,” he said. “I just received an updated document.”

Asked if he had sent this update on to the Battambang court, Dr. Chhi Vun said he was not sure.

“I don’t know,” he said. “You can ask the court.”

Court spokesman Toch Sopheakdey declined to answer questions about whether the court had received the test results.

“This is an internal issue of the court,” he said.

Other national and provincial health officials contacted on Monday said they did not know whether the court had received the requested medical evidence.

Ly Penh Sun, who replaced Dr. Chhi Vun as the director of NCHADS, referred questions about the Institut Pasteur’s analyses back to his predecessor.

“I do not know about these results that the court requested from Pasteur,” he said.

Voeung Bunreth, director of the Battambang provincial health department, said he had requested the institute’s findings on behalf of the provincial court, but he did not know if they were ever delivered to judicial officials.

“I just brought the letter from the court to give to the Institut Pasteur, but I don’t know if the court received the results or not,” he said.

Mr. Chrin’s lawyer, Em Savann, said he had not even known that the court requested the institute’s findings in the first place.

“According to what I remember, the presiding judge requested through the provincial health department that Yem Chrin’s blood be tested,” Mr. Savann said. “But I did not hear the presiding judge request the results of any other testing.”

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