Maharashtra fourth in country for such cases; activists say this calls for NAT to replace the long ELISA test currently used to detect infected blood
Representational picture
In the past 10 years, as many as 2,506 people in Maharashtra have been infected with HIV during blood transfusions. As per data procured through Right to Information (RTI), in 2018, Maharashtra recorded the fourth highest cases of people infected with HIV through blood transfusions in the country. Activists say that this again raises the need to introduce NAT (Nucleic Acid Test), as the current blood testing procedure with ELISA has a long window period, which often fails to detect the antibodies produced after HIV infection.
In 2008, the state recorded 373 HIV positive cases and was second after Gujarat with 592 cases. In 2010, 182 cases were detected while in 2015, 173 cases were detected. There were 190 cases registered in 2017. In 2018, the state registered 169 cases, making it the fourth state in India with highest number of cases after Uttar Pradesh (241), West Bengal (176) and Delhi (172).
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Why NAT
While the numbers have gone down over the years, they raise the need for better surveillance and more authentic testing. When a person donates blood, it goes through a series of tests to check if it is infected. Currently, as per NACO (National AIDS Control Organisation), blood is tested through ELISA, but it has a window period of weeks which often fails to detect the antibodies.
According to WHO, HIV infected persons develop antibodies to HIV antigens usually within 6 weeks to 3 months after being infected. In some individuals, the ELISA test may not be positive until 6 months or longer. The NAT is more capable of detecting infectious donations because it detects viral genes rather than antibodies or antigens (proteins from the virus) like ELISA. However, this test also takes about 20 days to detect the virus. "The government has been telling us for years, that they will make NAT compulsory for all donations but still they continue to use ELISA which is causing all these leaks in the system," said Chetan Kothari, an activist who had filed the RTI application.
Better surveillance required
Doctors have also raised the need for more medical staff for better surveillance during blood donation camps. In a recent case, officials from the Maharashtra State Human Rights Commission (MSHRC) and Brihanmumbai Municipal Corporation (BMC) commented that even NAT is not fool proof, so there is a need to provide sufficient staff for better surveillance during blood donation camps.
"All the blood banks just run after collecting the highest quantity of blood in haste without the presence of enough qualified doctors. Doctors often skip camps. Qualified pathologists don't check the samples properly and just sign reports," said a senior doctor from a civic-run blood bank. When contacted, NACO Deputy Director General Dr Naresh Goel refused to comment. Dr Padmaja Keskar, project director for Mumbai District Aids Control Society said she was travelling when contacted.
2,506
No. of people infected with HIV in state in past 10 yrs
HIV stat(e)us
Number of HIV infections registered in 2018
Uttar Pradesh2 41
West Bengal 176
Delhi 172
Maharashtra 169
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