All-India Institute of Medical Sciences (AIIMS) on Saturady made public its report on the necessity and feasibility of ‘NAT testing’ in individual blood doners.
As a result of the first-ever large scale evaluation in an Indian Government setting, AIIMS concluded that said with the current testing methods it is difficult to identify the viruses during the ‘window period.’ In this phase the virus is multiplying in the body but the donor may unknowingly donate infected blood.
The study had also sought to identify the risk of HIV and hepatitis transmission from blood transfusions and the ability of NAT to intercept and prevent this risk.
Presenting the results at a press conference, principal co-ordinator of the study and AIIMS faculty in-charge Blood Bank Dr. Kabita Chatterjee said: “We compared NAT tests with the standard testing methods in use and found that with the current testing methods it is difficult to identify the viruses during the ‘window period. Moreover, each bag of donated blood collected can be transfused in up to three patients. With 7.4 million blood donations collected annually in India, that equates to more than 6,000 donations potentially missed with existing testing technologies, and up to 20,000 patients and families being adversely affected.”
Dr. Kabita further added: “A new molecular technology based on the principle of Transcription Mediated Amplification (TMA) enables magnification of even very low amounts of viral genetic material, and allows for individual donation testing (IDT) to maximise test sensitivity. Given the frequent presence of low viral concentrations in many blood donation samples and the high viral prevalence in the Indian setting, TMA in IDT format is ideal to ensure maximum possibility of viral interception. Broad based NAT implementation is necessary and feasible in India.’’
The study also confirms the feasibility of NAT testing in India, both in the government and private setting. Noting that NAT was already available in the Country P. D. Hinduja Hospital, Mumbai Transfusion Medicine consultant Dr. Anand Deshpande said “NAT is part of the routine testing in 12 blood centres across India such as AIIMS, Hinduja Hospital, RML Hospital, Apollo Hospital and others. Implementation of NAT is an important step forward in the prevention of transfusion transmission infections in India. In fact, the government and various blood banks have already planned adoption and implementation of NAT to increase the availability of a safer blood supply.’’
Institute of Immunohaematology, Mumbai director Dr. Kanjaksha Ghosh said: “The `NAT Experience’ study has highlighted the need for a patient-centric approach to blood safety by making tests like NAT mandatory in India and to ensure we have the safest possible blood supply in India.’’
The ‘NAT Experience’ study is going on in three other centres across India, and is being supported by Novartis Diagnostics through an unrestricted grant.
Given the high prevalence of hepatitis and HIV in India, the Union Government had made blood screening mandatory in 2000. However, existing standard of care (ELISA serology testing) in India continues to allow a ‘window period’ between viral infection and viral detection. Unlike countries where compulsory NAT has ensured the safest blood supply possible, NAT is still not mandatory in India.