**Bhubaneswar:** As per the data released by the National AIDS Control Organisation (NACO), as many as 2,234 people contracted the human immunodeficiency virus (HIV) after receiving blood transfusions in hospitals across India between October 2014 and March 2016, but the Government told Parliament it did not know of these infections.
The information was made available by NACO when it replied to a right-to-information (RTI) request filed by activist Chetan Kothari earlier this year.
Meanwhile, with four shocking cases of human immunodeficiency virus (HIV)-infected blood infection reported in Odisha recently, question has been raised on the safe blood transfusion and also finger pointed at the lack of facilities in the main hospitals across the State here to stem such rot.
In the last three months, since June this year, four such horrifying cases have been reported from the Veer Surendra Sai Medical Institute of Science and Research (VIMSAR) at Burla in Sambalpur district, Balasore District Headquarters Hospital and latest from the MKCG Medical College and Hospital at Berhampur.
In the VIMSAR case, Odisha Government suspended the blood bank chairman Rajendra Patnaik for the reported transfusion of infected blood to two patients there. Besides, the Health and Family Welfare Department also dismissed laboratory technician and data entry officer of the government-run medical citing ‘administrative lapses’.
The action came after reports of botched blood transfusion came to the fore. According to reports, two patients undergoing treatment at the premier government-run medical college and hospital were allegedly transfused HIV and Hepatitis C blood.
Notably, a 60-year-old patient from Brajarajnagar in Jharsuguda district was admitted to the hospital on June 12 for leg surgery. Another person hailing from Rairakhole in Sambalpur district was admitted to the surgery ward of the hospital on June 9 due to stomach pain and was allegedly transfused with the HIV-infected blood.
Two days after such cases at VIMSAR reported, another allegation of the same nature came to fore in Balasore.
Family members of Tajeen Parween, a 3-year-old girl suffering Thalassemia, alleged that their daughter got infected blood from the Balasore Red Cross Blood Bank.
Family members of the little girl blamed the Red Cross authorities as their daughter took blood only from there.
A Thalassemia patient requires frequent blood transfusion along with drugs to remove the high iron deposits in body and organs.
The latest case in point is that of the Berhampur MKCG Medical College and Hospital. A 4-year-old child was diagnosed having HIV positive blood.
The minor boy was detected to be suffering from Thalassemia when he was just six months old.
He has been having blood transfusion on a regular basis from the MKCG Blood Bank, and had been administered 68 units of blood till the case was detected.
A few days back, he became unwell, which prompted the doctors to conduct a blood test.
According to the report, his blood was diagnosed HIV positive. To know the source and cause of this infected blood, his parents had a blood test conducted in which the reports were negative.
Need to be mentioned here that, despite the NACO released data, “No” was the reply by the Ministry of Health (NACO’s parent organisation) on August 16, 2016 to a question from Congress Member of Parliament and former minister Jyotiraditya Scindia asking if the Government was aware that “a large number” of people nationwide had been infected with HIV while getting blood transfusion.
“The limitations of available testing methods while screening blood units for HIV in blood banks as a result of which possibility of HIV transmission during blood transfusion cannot be completely ruled out,” the Health Ministry said in its reply.
However, NACO disputes the reliability of the data it released, claiming that it “refers to information on self-reported transmission of HIV”, and is “not corroborated by any scientific means to confirm that transmission is indeed due to blood transfusion”.
Blood transfusion is deemed “as an acceptable way of getting infected, rather than others showing bad lifestyles”, said Zarin Bharucha, pathologist and chairperson of Federation of Bombay Blood Banks.
Blood transfusions account for 0.1 per cent of HIV infections, according to data released in the Lok Sabha reply, but based on NACO figures, it would account for 1.7 per cent.
Either way, the number of HIV infections through blood transfusions should be zero: the US reported its last such case in 2008, the UK 2005 and Canada 1985.
It is mandatory for hospitals to screen donors and donated blood for what are called transfusion-transmitted infections, such as HIV, hepatitis B and C, and malaria. That isn’t always done, and when it is, the chances of ruling out HIV-positive blood are not 100 per cent.
There is a window between the contraction of the virus and the production of anti-HIV antibodies in the blood that leads to the virus being undetected by tests. This period varies depending on the sensitivity and specificity of the test.
“The blood transmission mainly occurs in this period,” said Bharucha. “Most of the (blood) banks use recent testing to shorten the window period, but these tests are expensive, so they are not used in many government-run hospitals.”
Introduced in 2001, the nuclear acid amplification test has reduced the length of time HIV might be undetected to between seven and nine days, from two weeks and some months previously.
Some states lack adequate HIV-testing facilities. In Jharkhand, 17 of the 24 districts did not have test facilities, according to a 2015 India Today report.
The lack of testing facilities leads hospital staff to rely on what is called “pre-donation history”, an account of donations made by a donor.
“Relying on pre-donation history means if donors do not give personal history correctly, their blood is at risk,” said Bharucha.
In a country where being HIV positive is still considered a social stigma – infected people tend to hide the fact – not testing blood and donors is a gamble, as is the practice of using what are called “replacement donors”.
Hospitals short of blood often ask a patient’s family to find a donor. “Not everyone has a donor available, so they might land up getting a paid donor,” said Bharucha. Even if paid blood donations are forbidden (the Supreme Court banned them in 1996), they still take place, increasing the chances of patients getting blood that is HIV positive.
“Awareness is the key to tackle this issue,” says Bharucha. “Communities should be aware of the danger of this practice.”