Experts and patients on Tuesday demanded access to standardised blood screening technology to prevent transmission of infectious diseases such as hepatitis B, C or HIV, through blood transfusions.
They emphasized on the importance of standardising pre-transfusion screening, citing a National Aids Control Organization (NACO) report that says transfusion transmitted infections (TTIs) account for over 1,300 HIV infections across India in 2018-19.
Many patients who have surgery or are involved in an accident, are undergoing cancer treatment, or are treating ailments with whole blood or blood components require blood transfusion.
Therefore, it is important to screen donated blood with globally accepted technologies. Some transferable infections such as HIV, can endure in blood and infect the person receiving the blood transfusion, Dr Anju Uppal, Director of IMA Blood Bank, Bareilly said.
There are a total of 2,626 functional blood banks in the country, according to the National AIDS Control Organization (NACO) baseline assessment of blood banks conducted in 2016, Dr M K Singh, consultant physician at Flores Hospital Pratap Vihar, Ghaziabad, said.
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"India needs about 12.2 million units of blood per year, out of which only 11 million units are available. With such a shortage, it is very easy not to focus on safe blood transfusion.
"However, unsafe blood transfusions with TTIs could be a bigger challenge for patients to recover. A report released by NACO reveals that 14,474 cases of HIV have been caused due to unsafe blood transfusion in India," Singh said.
Blood transfusion is an important aspect of patient management. Complications in blood transfusion can lead to TTIs like HIV, Hepatitis B (HBV) and Hepatitis C (HCV) among others, further risking the life of the patient receiving blood.
"NAT technology was implemented in IMA Blood Bank, Bareilly in August 2016. We primarily screen the donated blood unit under Elisa technology and all those units that are tested negative in this technology are subject to NAT testing.
"From one whole blood unit donated, three components are prepared and issued to three patients. I advocate safe blood transfusion for all patients. There is no 'Zero risk' or 100 per cent safe blood available as of now. But all blood banks should provide the safest possible blood using the best technology for screening viral markers like Hepatitis B, C and HIV 1 and 2," Uppal said.
He said NAT is the answer to this need as it has the smallest window period amongst all methods available.
The window period is the time between when a patient is infected and when they show up as positive by the routine mandatory antigen/antibody tests.
NAT directly detects the genetic material (RNA and DNA) of the viruses like HIV, Hepatitis B and Hepatitis C.
It is the most sensitive technique for detection of infections in donated blood that is currently available across the world.
"Considering the window period of detection is shorter for NAT, TTIs can be significantly reduced amongst recipients of NAT-tested blood.Further, I would request the general public to come forward and donate blood. Blood of repeat voluntary blood donors is the safest for transfusion as they are regularly screened for TTIs," Uppal added.
With the AIDS Awareness month underway, it is important to emphasise on the need to establish a Quality Management System that ensures safe blood transfusion.
As per the WHO report, at the end of 2018, an estimated 79 per cent of people living with HIV knew their status. Thus, early detection could avoid high risk behaviour thereby saving millions of lives, the doctor said.
The introduction of NAT will significantly increase blood safety and reduce many such risks of TTIs-associated morbidity and mortality. Many countries across the world have mandated NAT in blood testing for transfusion, Uppal said.
According to the WHO recommendations, each country should have a national policy on blood screening that defines national requirements for the screening of all whole blood and apheresis donations for transfusion-transmissible infections.
Anubha Taneja Mukherjee,Member Secretary, Joint SecretaryThalassemics India andThalassemia Patients Advocacy Group (TPAG)said, "I was a Thalassemia major by birth, which meant that I needed blood transfusion every 15 days. What followed when I was 16 years old remains a cause of anxiety and fear to date! I was diagnosed with Hepatitis C on account of unsafe blood transfusion and my life changed."
"That's when I began my crusade to prevent anyone needing blood transfusion from contracting an infection like me. I have benefitted support of central government like many other thalassemics who also have been receiving world class treatment in terms of drugs and I will hate to see all the national money go waste because of random infections through unsafe blood transfusion.
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