Against the backdrop of revelations by National Aids Control Organisation (NACO) that around 1,000 people have contracted human immunodeficiency virus (HIV) in Maharashtra due to blood transfusion, state health ministry is planning to introduce nucleic acid amplification testing (NAT) tested blood across the state in consultation with the Union health ministry.
"Maharashtra government would be a pioneer in introducing this for the first time in the country. The Union health ministry has assured all help for the project," said state health minister Deepak Sawant.
The project to be covered under the Project Implementation Plan (PIP) of National Rural Health Mission (NRHM) will envisage to provide NAT tested blood in Nagpur, Nashik, Pune, Thane, Amravati, Mumbai to begin with.
HIV in most blood banks is still tested through enzyme-linked immunosorbent assay (ELISA) test that has an innate shortcoming. If a person has recently contracted HIV, this test may not show it. It can detect HIV antibodies that take a minimum of three months to show in the blood. ELISA is a plate-based assay technique designed for detecting and quantifying substances such as peptides, proteins, antibodies and hormones. It is a fundamental tool of clinical immunology, and is used as an initial screen for HIV detection. According to experts, blood banks need to upgrade to advanced tests such as NAT, which today costs Rs. 1,200 per unit as per the new gazette notification released in June, 2015.
NAT tested blood would be a blessing in disguise as there has been rampant violation of blood donation guidelines during voluntary blood donation camps which has dealt a severe blow to blood safety across the state. Any person who tests positive for HIV during a donation camp is seldom informed about his status or referred to an Integrated Counselling and Testing Centres (ICTC), although both are mandatory.
In order to ensure blood safety, experts advocate the need to use only HIV-screened blood, use blood judiciously - only when it is really indicated, preferably use fractions (plasma, platelets or red cells) than whole blood and avoid its commercialisation and follow the highest standards of medical ethics. Use donor deferral if any high risk activity among donors is suspected during counselling, use pool testing (pooling of 10 samples and doing test at one place to reduce cost of tests like Polymerase Chain Reaction (PCR) or NAT.
To track adverse reactions associated with blood transfusion and blood product administration, Haemovigilance Programme of India (HvPI) at the national level was launched on December 10, 2012 by the ministry of health and family welfare (MoHFW).
It aims to identify trends in adverse reactions and events, thereby to form transfusion policy, target areas for improvement in practice, stimulate research, raise awareness of transfusion hazards, give an early warning of new complications to improve safety of transfusion for patients.