Recently, a 3-year-old boy in Hyderabad, who was suffering from thalassemia, tested positive for HIV after blood transfusion.
Lack of testing facilities and funds are the two major reasons due to which safety of transfusion is compromised. (Creative Commons)
The risks of contracting infections through blood transfusion have increased due to a lack of the latest testing facilities and a funding crunch, say the officials of blood banks in Hyderabad.
They told South First that these are the two major reasons why the safety of blood transfusion is compromised in their facilities.
The issue of risks of blood transfusion came to the fore after the father of a three-and-a-half-year-old Hyderabad boy recently filed a police complaint alleging that his son contracted HIV infection from the blood transfusion performed at the city’s Indian Red Cross Society blood bank.
The boy, who is suffering from a rare blood disorder, Thalassemia, regularly got blood transfusions at the blood bank until one day the doctors there informed his parents that he had tested positive for HIV.
While blood transfusion is an integral and life-saving procedure of modern medicine, it is not an entirely risk-proof method, as per a study.
Life-threatening Transfusion Transmissible Infections (TTIs) infections like HIV, hepatitis B, and hepatitis C are found to be the prevalent among a small percentage of voluntary blood donors in the rural parts of the country, finds the study.
The study found that about 0.66 to 12 percent of the donors tested positive for hepatitis B, 0.5 to 1.5 percent for hepatitis C, 0.084 to 3.87 percent for HIV, and 0.85 to 3 percent for syphilis.
The major challenge faced by blood banks is the inability to detect the virus during the window period, authorities say.
“If someone has unprotected sex with a person infected with HIV and donates the blood within few days, the HIV present in the donor cannot be detected in the tests. The donor’s blood will be transfused to any person in need, which can lead to TTI,” an Indian Red Cross Society, Hyderabad, official told South First.
The viral window period is the time between the viral exposure and the time it takes to get detected by tests. It also depends on the type of test employed.
“Modern testing facilities can detect the HIV virus within seven days of incubation, while some tests detect the virus after 90 days. The incubation day can be reduced with better facilities,” Dr Suman Jain, CEO of the Thalassemia and Sickle Cell Society in Hyderabad, told South First.
The transmission of TTIs can be significantly reduced with the use of latest technology to test blood.
“The testing facilities have improved over time. But according to the government guidelines, most labs still depend on the ELISA test. Even the latest third-generation ELISA test takes nearly four to six weeks’ time to detect the virus,” Dr Jain told South First.
The blood, transfused to the Hyderabad boy who later was tested positive for HIV, was also tested using the ELISA method at the Indian Red Cross Society.
“We conduct a test using a latest Electrochemiluminescence (ECL) technology at our laboratory. Its window period is between 10 and 14 days. These tests help in identifying the blood contents, even in grey areas. We discard the blood in the grey area. We also discard around two percent of blood above the grey area,” said Dr Jain.
He also added that a new technology — NAT (Nucleic Acid Test) or ELISA fourth-generation technology can help in detecting the virus within a week and can give 99.9 percent accurate results.
“But the cost is quite high,” added Jain.
Officials at the Red Cross Society in Hyderabad said that running the blood bank costs around ₹1,200 per unit of blood.
“The cost includes providing blood bags for donations, testing of blood, treatment of the patients, and so on. If we are treating hundreds of people in a day, it crosses crores,” said one official.
“Running a blood bank is about ensuring the safety of blood which requires a lot of money. Treating a thalassemia patient costs ₹1,200 per unit, and if we are looking for new technology to test the blood, it requires another ₹1.000 per unit,” said Dr Jain.
“Blood banks cannot do everything. Otherwise, we have to charge the patients and who will give ₹3,000 for a unit of blood? We need government intervention and funds for this, which we mostly lack,” said Dr Jain.
The Red Cross Society official said that there should be a strict selection of blood donors with the emphasis on getting voluntary donors.
The official added that a comprehensive screening of donors using different testing methods should be done to ensure the safety of blood for recipients.
Dr Jain adds that before getting the blood, the history of the donors should be examined carefully.
“If they have had a fever, rashes in the past few weeks, blood should not be taken from them. Voluntary donors should be prioritised instead of professional donors. Close family members are the best donors,” said Dr Jain.
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