Outdated blood testing contributes to HIV

[Guest guest]

Outdated blood testing contributes to HIV

IANS, Jan 7, 2011,

Hundreds of thalassemic children get infected with HIV-AIDS every year during

crucial blood transfusions as most blood banks, including the Indian Red Cross,

are not equipped with an advanced blood testing facility that can detect the

virus accurately and in a short time, say experts.

Over 12,000 thalassemic children are born in India every year, and nearly one

fourth of them fall prey to HIV-AIDS in the course of their treatment at

state-run hospitals.

Most hospitals use the outdated ELISA test on donor blood, which is

time-consuming and not 100 percent accurate. The advanced Nucleic Acid Testing

(NAT) technology that can accurately detect the AIDS virus is available with

only three state-run blood banks in the capital - the All India Institute of

Medical Sciences (AIIMS), Ram Manohar Lohia hospital (RML), and the Army

Research and Referral hospital.

Thalassemia, a genetic blood disorder affecting over 30 million children in the

country, requires blood transfusion every 15 days as the bone marrow fails to

form a part of the vital haemoglobin protein carrying oxygen from the lungs to

the rest of the body.

The lack of the latest technology at blood banks has made thalassemic children

most susceptible to HIV-AIDS.

" The problem lies with the outdated blood testing method we have. Nucleic Acid

Testing (NAT) of donors' blood needs to be implemented in all the blood banks as

the technique reduces the window period or period of detection of HIV and other

viral infections, " J.S. Arora, general secretary of the National Thalassemia

Welfare Society, told us.

" The ELISA detects HIV infection in the donor's blood only by the 23rd day of

virus-contraction. But with NAT, this is reduced to 5.6 days, " added Arora.

The largest blood bank in the country, Indian Red Cross, is also not equipped

with NAT.

NAT reduces the window period or the period of detection of HIV and other viral

infections. However, it costs the blood bank Rs.1,000 to test every sample.

The window period is the time frame in which a particular infection can be

detected after the time of contraction.

" If the hospital is able to detect the infection at the time of donation, it is

fine. But if it fails, the virus in the blood is passed on. Even hospitals can't

be blamed, " Bharat Singh, from the State Blood Transfusion Council in the

capital, told us.

" Either we wait for the 23 days for the HIV infection to show itself before

transfusing the blood, or we get the NAT. But sometimes the infection escapes

the test in case of ELISA test, " explained Singh.

Most government hospitals in India use the much cheaper ELISA test kit that

cannot detect HIV before 22 days of infection, Hepatitis B before 59 days and

Hepatitis C before 82 days. The ELISA test costs the hospital between Rs.50-100

per blood sample.

In July 2010, at least 56 children suffering from thalassemia had tested

positive for HIV, Hepatitis B and Hepatitis C after receiving blood transfusion

at the government-run Umaid Hospital in Jodhpur.

While health experts have maintained a united opinion on mandating the NAT in

hospitals, the test is considered to be a one-time investment by them.

" A NAT machine costs around Rs.40-50 lakh; so it's a one-time investment for the

government. Considering that so many poor families are dependent on government

hospitals for blood transfusion, the government should not be this reluctant to

bring in NAT, " said V.P. Choudhry, former head of haemaotology at the AIIMS.

" The risk of infected blood transfusion can be brought down to near zero by NAT.

But NACO has been reluctant in recommending it, " added Choudhry.

For 15-year-old Mayank (name changed), life is all about coping with illness as

the child juggles between an Anti-Retro Viral Therapy (ART) Centre and a blood

transfusion unit in Uttam Nagar, a semi-urban locality in west Delhi.

" I am thalassemic and acquired HIV because of infected blood at the Kalawati

Saran Hospital in Delhi. I visit the ART centre every month to get my medicines

for HIV and also go for blood transfusion every 15 days, " said Mayank, who was

diagnosed with thalassemia in 1994, just seven months after his birth.

" When my son was diagnosed with HIV, doctors suspected it could have been

because of unsafe sexual relationship. But we both were HIV negative. Finally it

was realised that Abhishek acquired the infection because of infected blood, "

said Mayank's distraught mother, whose other son is HIV negative.

Mayank, a Class 10 student, aspires to study and become an engineer to match his

father's level of grit and determination.

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od-testing-contributes-to-HIV/articleshow/7235303.cms

[Guest guest]

Dear forum,

Re: /message/12405

The views expressed by the Thalasmic Society expert is absolutely correct.

The method of testing the blood for detection of HIV with the blood donors is 

not foolproof as per the version of the doctors in this column.

May I request the NACO which is the authority for the implementation of the 

NACP in India to consider the request of the Society involved in the treatment

of Thalasmic cases to provide atleast  the costly equipment in the Major Govt

 Medical Colleges Hospitals Blood Banks in all the States.

The Govt will have to issue similar requests in all the Govt approved private

Medical Colleges Hospital Blood Banks and approved Blood transfusion Centres to

provide the costly equipment to ruleout the  presence of HIV in all the States.

This will enable the public to have confidence in getting the blood tranfusion

in the neddy and emergency cases.

Now I happened to come across in few instances that the patient requires blood

tranfusion is expecting known relatives  are to be considered for the collection

of blood for tranfusion.

In my personal experience  I have done so for my daughter required blood

tranfusion during her LSCS delivery.Of course the blood group also matched from

her younger sister  who has donated the blood.

The case study given by the doctors is really to be taken seriously.

The viewers especially the NGOs and Medical experts can voice their concern to

the Government.

T.K.Satagopan

Consultant

e-mail: <tk_satagopan@...>