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Blood transfusions in India infect thousands with HIV

By Karen Graham     May 31, 2016 in Health
Delhi - India has over 2.9 million people living with HIV/AIDS. Thousands of these cases are the result of receiving contaminated blood through transfusions.
In the past 17 months, between October 2014 and March this year, some 2,234 persons across India have contracted the human immunodeficiency virus (HIV) following blood transfusion, according to data made public by the National AIDS Control Organisation (NACO).
NACO, part of India's ministry of health and family welfare, released the information in reply to a right to information (RTI) request by activist Chetan Kothari in April 2016, according to Quartz.
Blood transfusions are used when patients lose blood due to injury or during surgery. About 84 percent of the blood for transfusion in India is donated.
Based on the RTI query from NACO, the highest number of cases was found in the northern Indian state of Uttar Pradesh with 361 cases, while the capital city, Delhi was fourth with 264 cases reported. The western state of Gujarat was second with 292 cases and Maharashtra with 276 cases ranked third.
"This is the official data, provided by the government-run Naco. I believe the real numbers would be double or triple that," Mr Kothari told the BBC.
Mr. Kothari said that according to law, it is mandatory for hospitals to screen donors and the donated blood for HIV, hepatitis B and C, malaria and other infections. "But each such test costs 1,200 rupees ($18; £12) and most hospitals in India do not have the testing facilities. Even in a big city like Mumbai, only three private hospitals have HIV testing facilities. Even the largest government hospitals do not have the technology to screen blood for HIV," Mr Kothari said.
Under current practice in India, potential blood donors fill out a donor health questionnaire and receive a brief medical examination as well as predonation counseling. The donated blood is supposed to be screened for anti-HIV-1/2, anti-HCV, and HBsAg, RPR for syphilis, and a slide/card test for malaria.
The screening is done using the enzyme-linked immunosorbent assay (ELISA) and more frequently, nucleic acid testing (NAT). At least this is what the Indian government says is being done all across the country.
In 2015, there were 2,760 blood banks in India. The blood banks were in hospitals, including government-run facilities and specialized medical institutes, according to India's Central Drugs Standard Control Organization.
Yet despite the data provided by the Indian government, a paper published in the Journal of Blood Transfusion in November of 2014 gives us a very different picture. The paper goes under the title: "Screening Donated Blood for Transfusion Transmitted Infections by Serology along with NAT and Response Rate to Notification of Reactive Results: An Indian Experience"
In a nutshell, the writer says one major problem India is the poor response surrounding donor notifications when testing shows the presence of HIV. All reactive donors are supposed to be called or sent a letter informing them of the test results. Yet only about 23 percent of donors responded to notifications. Many more of these donors, rather than face the problem, just go to a different blood bank.
The author says that currently in India, most of the blood banks including his, do not have the facility to perform confirmatory tests for transfusion transmitted infections (TTI). Although the blood policy advocates disclosure of TTI status, donors are not, in practice, informed about their results. The onus lies with the donor to contact the blood bank, instead of the blood bank taking the initiative in contacting the donor.
India relied heavily on foreign support in running transfusion services for years. Not long ago, they opted to take over, and while generally doing a good job of reducing the number of HIV infections from blood transfusions in India from 8 percent 20 years ago to about 1 percent today, the problem still doesn't seem to be under control. As Mr. Kothari says, "This is a very serious matter and must be addressed urgently."
More about India hospitals, Blood transfusions, infected with HIV, cost of testing, Mandatory
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