Outdated blood testing contributes to HIV among thalassemic kids

NEW DELHI - 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Most hospitals use the outdated ELISA test on donor blood, which is time-consuming and not 100 percent accurate.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“The problem lies with the outdated blood testing method we have.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 IANS.

“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 IANS.

“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.

(Madhulika Sonkar can be contacted at madhulika.s@ians.in)