A 23-year-old pregnant woman in Tamil Nadu tested positive for HIV after receiving a unit of blood at a government hospital blood bank.
What is the mandate?
Testing all donated blood units for a number of transfusion-transmissible infections, including HIV, is mandatory in India.
The ELISA test is used in all blood banks to screen for HIV.
Notably, ELISA test has very high levels of sensitivity to diagnose samples positive for the virus.
Since 2004, the National AIDS Control Organisation (NACO) Action Plan-specified guidelines are being followed.
All blood banks are required to obtain from donors a written consent on their wish to be informed about a positive test result.
In case of testing positive for HIV, blood banks are required to refer the donors to designated voluntary counselling and testing centres (VCTCs) for disclosure and counselling.
VCTCs are required to inform the blood bank of a donor’s status only when the confirmatory test done at the VCTC too is positive.
This is to stop the person from donating blood in the future.
What happened in the recent case?
The donor’s HIV-positive status became known in 2016 when he donated blood at the same blood bank.
This particular donor had consented to be informed of a positive result.
It is said that the blood bank tried but failed to contact the donor in 2016 to inform him of his HIV positive status.
But recently he had found out elsewhere that he was HIV-positive, and dutifully contacted the hospital.
But his blood (recent donation) had already been transfused to the pregnant woman.
The donor passed away after consuming poison following the incident.
What is to be done?
Blood banks in India have a success rate of less than 50% in contacting donors testing positive for transfusion-transmissible infections.
Only half of the consented donors are contactable and even fewer visit a VCTC.
So NACO should address the lapses in screening procedures and also find a viable alternative to contact them without compromising the donor’s identity.
The focus should also be on creating awareness among donors to visit a VCTC to confirm their HIV status when alerted by blood banks.
