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Live chat: HIV through bad blood transfusions

4:57 p.m.: Welcome to The Hindu's live chat on HIV through contaminated blood transfusions.

4:58 p.m.: In the last 17 months alone, 2,234 persons across India have been infected with human immunodeficiency virus (HIV) while getting blood transfusions. The maximum number of such cases — 361 — was reported from Uttar Pradesh due to unsafe blood transfusion practices in hospitals. Read our article

5:00 p.m.: With us today, we have our Health and Science Editor Vidya Krishnan, Chapal Mehra, Senior Director, Global Health Strategies, Leena Menghaney, HIV activist and lawyer, and Dr. Shobini Rajan, Assistant Director General, NACO.

5:06 p.m.: Leena Menghaney:

Welcome the fact that NACO made the data public and it should bring back focus on the blood safety programme which functions not only to reduce the risk of HIV from blood transfusions but also HBV, HCV and other infections.

5:08 p.m.: Dr Shobini Rajan:

Let me clarify at the outset that the data in question is self reported information obtained during post test counselling of positive clients, as to what they think is their possible mode of having contracted HIV infection.

5:08 p.m.: Vidya Krishnan:

Hi leena, Thanks for joining

5:08 p.m.: Dr Shobini Rajan:

Hello to everyone.

5:08 p.m.: Comment From Guest

Shobini/ Leena: one of major issues with this data set is that it is self reported-- patients walk in months after a transfusion and realise they are infected. How reliable do you think this data is

5:09 p.m.: Comment From Michael Reto

Where can I get myself tested for HIV?

5:09 p.m.: Vidya Krishnan:

So, Dr Rajan, are you saying this data could be inflated? Or could be an underestimation since there is no scientific way to track it?

5:10 p.m.: Dr Shobini Rajan:

It certainly is authentic data. However it only lets us know that transfusion of infections through blood exists, but that is a known scientific fact.

5:10 p.m.: Chapal:

I think the data points to some important limitations within our ability to prevent HIV . Infected blood is something we should be able to control at all costs. This data set though self reported points to several changes within the system

5:10 p.m.: Vidya Krishnan:

Leena, as an HIV activist do you feel that everything that needs to be done is being done by the government when it comes to ensuring the safety of blood products?

5:10 p.m.: Comment From Rajneesh Salgotra

Blood banks in India must be taken under some regulation now.

5:10 p.m.: Comment From Guest

Greetings! Isn't a check done on the blood samples when it is donated?

5:11 p.m.: Dr Shobini Rajan:

Michael, you could go to the nearest Integrated Counseling and testing centres in any government or private set up for the same. List is available on NACO website

5:11 p.m.: Vidya Krishnan:

Chapal: do you mean it is possible to reduce this data to zero?

5:11 p.m.: Dr Shobini Rajan:

Blood Banks are under regulation of State FDA and work with a license issued through Drug Controller General of India

5:11 p.m.: Comment From ravi kumar

i just want to know, is there any timely routine visit from the govt. officials for the facility livecheck and most importantly, are they been updated and reminded as an exercise so important?a little away from the discussion.

5:11 p.m.: Chapal:

I think that claim would be questionable. But it is certainly to control this to a minimum

5:12 p.m.: Comment From Nathan

Do we have more information on where exactly is the issue ? it is the collection process or storage ? Who are all responsible for this ?

5:12 p.m.: Chapal:

The government has done good work in this regard earlier . I think what is needed is a renewed focus

5:12 p.m.: Vidya Krishnan:

And isnt this a minimum figure? 2234, given the sheer scale of the programme?

5:13 p.m.: Dr Shobini Rajan:

The blood banks are visited by State FDA to check compliance to license requisites periodically. Additional visits are also made by the officers of State Blood Transfusion councils and Blood Transfusion Experts.

5:13 p.m.: Leena Menghaney:

we know that blood safety programme has many challenges including the fact that often relatives donate and the blood goes untested or there are gaps in the manner private blood banks function

5:14 p.m.: Chapal:

Considering the scale of the program this figure may be considered acceptable by some but I think the program itself would find these figures alarming because it points to trends .

5:14 p.m.: Leena Menghaney:

It is important that all those who test HIV+ are counselled and offered treatment

5:14 p.m.: Comment From Anil

This actually questions when we donote blood .. Can we donate without any fear .. because we might get infected with HIV if we give blood with contaminated needles ...

5:14 p.m.: Vidya Krishnan:

Dr Rajan, could you respond to what Chapal said about the acceptability of the numbers?

5:14 p.m.: Dr Shobini Rajan:

I tend to agree with Leena to the extent that in some states, especially in government facilities, replacement donation happens. But somewhere I would also evoke the responsibility of healthy members of society to walk to a blood bank and donate blood regularly

5:15 p.m.: Comment From Rudy

Does this mean that the checks and balances in place are not enough?

5:15 p.m.: Comment From raman

everyone should note that this fugure is a massive improvement from previous years

5:15 p.m.: Dr Shobini Rajan:

I would agree with Chapal that the numbers are not alarming in the perspective of the total HIV positives estimated, ie 2.1 million.

5:16 p.m.: Chapal:

Anil I don't think needles are reused . At least they are not supposed to be so donating blood should not infect people

5:16 p.m.: Comment From Shemy Rasheed

Transfusion is done in a new blood bag which has inbuilt needle. still there are chance to contaminate?

5:16 p.m.: Dr Shobini Rajan:

We can donate without fear, as that does not impose any risk whatsoever of transfusion transmitted infections

5:17 p.m.: Dr Shobini Rajan:

Needles are attached to the bag and cannot be reused

5:17 p.m.: Comment From koushik

Hello every one this is Koushik, who is responsible for this incident and what kind of reasons behind it. Another thing is in our country we didnt have sufficient preservative centers to store the blood. So what kind of measures we have to take to avoid such problems

5:17 p.m.: Vidya Krishnan:

Dr rajan: If we are to achieve the ambitious 20-20-20 vision, how do we aim to further reduce these errors?

5:17 p.m.: Leena Menghaney:

Anil the risks are at the time of receiving blood and people should always ask whether the blood was tested - not just for HIV but for Hep B and Hep C

5:18 p.m.: Comment From raman

We must first punish those facilities that do not do mandatory screening and offer compensation for the poor victims

5:18 p.m.: Leena Menghaney:

one issue is the shortages of testing kits. I hope that NACO is addressing this gap

5:18 p.m.: Vidya Krishnan:

Leena: you think patients who declare transfusion as the point of infection could be doing so because of the stigma?

5:18 p.m.: Dr Shobini Rajan:

Koushik, this is not an incident. Blood transfusion is one of the known means of transmission of infections. CHecks are in place though to make every blood bank mandatorily screen for five infections prior to accepting the blood unit. Each donor is also screened through questionnaire and examination before he is accepted as a donor

5:19 p.m.: Vidya Krishnan:

Dr Rajan: If you could respond to Leena on the massive shortage of vial load testing kits.

5:19 p.m.: Dr Shobini Rajan:

All those who need blood should take it only from a licensed blood bank and at the prescription of a qualified medical practitioner. Blood is to be used rationally, and only when really needed.

5:20 p.m.: Vidya Krishnan:

Chapal: How big is the problem of majority blood donors not being aware of their HIV status?

5:20 p.m.: Comment From Tam

At which stage of the process does contamination usually play a role? Is there a way to find this out?

5:20 p.m.: Leena Menghaney:

yes its possible that patients feel safe claiming that they were infected from transfusion. those who become HIV+ due to blood transfusion are seen as innocent victims

5:20 p.m.: Dr Shobini Rajan:

Leena, presently there are kits available through the programme for those blood banks which are supported through it, and there is no shortage.

5:20 p.m.: Chapal: I think the story points to the need of reviewing our overall strategy for HIV prevention. This is just one of the modes of transmission. We know that injecting drug users are not getting the attention they need as are sex workers

5:21 p.m.: Dr Shobini Rajan:

States and blood banks also have standing instructions to procure through their resources to mitigate stock outs so as to ensure mandatory blood testing.

5:21 p.m.: Chapal:

I think a lot of people are not aware of their status. There isn't enough testing . Also I think there is the window period where patients often test negative

5:22 p.m.: Vidya Krishnan:

Yes Chapal. But this story is creating such strong reaction because the people who are not from high risk groups feel unsafe about the systems in place to ensure blood safety.

5:22 p.m.: Dr Shobini Rajan:

Leena, agree. It is easier for the newly positve client to say he got HIV through blood, than to reveal his sexual inclination or needle sharing behaviour.

5:22 p.m.: Vidya Krishnan:

So, Dr Rajan, could it be possible that this data set is exaggerated ?

5:23 p.m.: Comment From pius

What is accuracy rate of a HIV test?

5:23 p.m.: Dr Shobini Rajan:

Chapal, to further add on to the window period, there is this period in the course of an infection when it cannot be detected by any known test. WHO also describes an eclipse period where the infection cannot be detected even through NAT and molecular tests.

5:24 p.m.: Comment From Deepak

So either we have get the entire blood packets tested in all labs which will not be the case , or based on the case to case basis , when ever there is need for blood , that blood should be certified by labs that it doesnt contain HIV.

5:24 p.m.: Vidya Krishnan:

So, there are always going to be cases that fall within this bracket? Of getting unsafe blood?

5:24 p.m.: Leena Menghaney:

those are very few cases

5:24 p.m.: Dr Shobini Rajan:

Vidya, this data set is accurate, but it requires to be interpreted with the denominators and with trend data over a period of time, only then can we really understand it.

5:24 p.m.: Chapal:

or ideally should be very few cases

5:25 p.m.: Leena Menghaney:

actually it would be interesting to see data on all five infections that the programme tests for

5:25 p.m.: Vidya Krishnan:

Dr Rajan/ Leena and Chapal: Would it not be wise to have regular voluntary donors, check their status before they donate?

5:25 p.m.: Dr Shobini Rajan:

Licensed blood banks label the tested blood units as free from HIV,HBV, HCV, malaria and syphilis. They are required to do so under regulation.

5:25 p.m.: Comment From Guest

Hello I am Ped Hemato-Oncologist and I think the problem in India is lack of "strict regulations" for blood banks and also for administering blood products by doctors!!

5:25 p.m.: Comment From Goutham

I have donated blood a once . But never do i think that it was checked for HIV . Unknowingly people which HIV might be donating blood . How do we check this ?

5:25 p.m.: Comment From Deepak

Are all hospitals equipped in India to test HIV ?

5:26 p.m.: Dr Shobini Rajan:

Responsibility also lies with entertainment industry who still picturizes blood transfusion in the Amar Akbar Anthony style, whereas it is nowadays a highly specialized activity.

5:26 p.m.: Chapal:

All blood banks are supposed to check for all these infections. There are lapses but it's standard procedure

5:26 p.m.: Comment From Dr Shaik Nishan Ashraf

For every transfusion the recipient has to accept the risk of the donor being in the window period.

5:26 p.m.: Comment From Murali

Usually how long is this window period? Will it be possible to get blood, screen it and then wait for few days and screen it again and then provide it for the patients?

5:27 p.m.: Dr Shobini Rajan:

Vidya, we prefer repeat blood donors for the same reason as they are undergoing regular check and proving themselves to be free from infection each time they donate.

5:27 p.m.: Comment From Deepak

Yeah even i agree that enforcement is not stringent especially in govt hospitals !

5:27 p.m.: Chapal:

Also we need to go back to the point about counselling for donors as well to help the, understand the risks

5:27 p.m.: Vidya Krishnan: Chapal/ Leena/ Dr Rajan: Do rigorous is the process process of licensing blood banks in India? The "deemed renewed" policy needs a rethink, yes?

5:28 p.m.: Dr Shobini Rajan:

@Murali, the window period depends on the test used and the infection screened for. It may vary from few days to few weeks. And window period does not apply to blood already collected. That has to be used within its expiry period, ie 35-42 days.

5:29 p.m.: Chapal:

I think more than the policy it's the implementation . We tend to fail there more than anything. Most government departments are short staffed and there is a lot of gaps at the state level

5:29 p.m.: Dr Shobini Rajan:

Vidya, the Ministry has in policy accepted that there should be no mushrooming of clustering of blood banks and capacity of existing blood banks is to be enhanced. This will lower the load on the system as far as monitoring goes.

5:29 p.m.: Comment From Guest

Hello Thank you for reply regarding regulations--I understand blood banks are required to do so but the standards are poor of state run banks and some private banks...doctors also do not get informed consent regarding Hepatitis and HIV risk--from patients---some doctors transfuse blood products right and left without understanding the indications properly because there are no "watchdogs" and there are no "guidelines"

5:29 p.m.: Chapal:

I think the reaction that this article has caused makes us realise that the one area where we have all failed is stigma reduction and community education. In any case as Dr Rajan pointed out this is still a lower risk form of transmission. We seem to want to panic without sufficiently interpreting the data and contextualising it

5:32 p.m.: Vidya Krishnan:

Yes.

5:32 p.m.: Dr Shobini Rajan:

Totally agree, Chapal.

5:32 p.m.: Vidya Krishnan:

Unfortunately, the HIV prog has been suffering from stock outs and budget cuts without provoking the lay people. In this report, the regular citizens feel threatened..

5:33 p.m.: Chapal:

I think it would be a good starting point to restart and reinvent the HIV community education programs, medical education programs and other key stake holders

5:34 p.m.: Vidya Krishnan:

Hence the reaction. Having said that, for the 2000-odd people who did get infected in the last 17 months, the story does stand true.

5:34 p.m.: Comment From Dr Shaik Nishan Ashraf

It has to be understood that blood transfusions are made when there is an absolute indication. At that point in time, if the doctor loads the bystanders and the patients with the rare yet possible side effects, there is a chance that a savable life is lost. Hence the quality of the blood banks, their adherence to norms and proper sentinel surveillance from the banks play a huge role.

5:34 p.m.: Dr Shobini Rajan:

I would use this opportunity to appeal to all eligible healthy people between 18 - 65 to donate blood and not let a situation of shortage of this commodity arise in India. Only 1-3% of our population needs to donate to meet our blood requirements.

5:34 p.m.: Comment From Tam

The govt cut and brought back funding for HIV in India. How effective has this been?

5:35 p.m.: Comment From Ravi Shah

Another point is--Thalassemia and hemophilia patients are big chunk getting transfusions. In both case u can avoid Blood products. In thalassemia by BMT and for hemophilia by giving factors!! But unfortunately by and large Indian helathcare sector still not providing curative treatment to these patients---Which is Shame for Progressive India as people have moved to cellular and gene therpies while we r still stuck with old ineffective supportive therapies!!

5:35 p.m.: Chapal:

I think it's a welcome move but the program itself has matured and the disease is changing too. There is a need for renewed strategy

5:36 p.m.: Dr Shobini Rajan:

What about pre-marital counselling and testing for Thal trait, to prevent??

5:36 p.m.: Vidya Krishnan:

Renewed in what aspects? I feel this story brings out the crying need to look at licensing process of blood bank, address the human resource shortages required to ensure that..

5:38 p.m.: Leena Menghaney:

one of the ways to reduce risks is to reduce the number of unnecessary transfusions which many medical practitioners encourage to earn money

5:38 p.m.: Chapal:

YEs it does . But we have to also remember that HIV is no longer regarded as a burning problem in INdia as it used to be. We have made great progress but lots more need to be done. The reduced funding and personnel is helping the infection

5:38 p.m.: Dr Shobini Rajan:

Vidya, the blood banks, especially in the govt and charitable sectors are receiving support from the central govt under various health programmes, but ultimately the States have to own up to provisioning the basic necessities at blood banks.

5:38 p.m.: Comment From Dr Shaik Nishan Ashraf

Bone marrow transplantation and Factors are very expensive propositions for the patient. And from the Government's side, it would accrue a huge burden if such therapies are made the norm. Even so, Govt of Kerala has been providing for eligible candidates, I having personally met a few.

5:39 p.m.: Comment From Dr. Rangarajan

@ Dr. rajan , just a FBE along with Fe studies can point to a Thal trait , the MCV can be a guide

5:39 p.m.: Vidya Krishnan:

The states have faced serious problem getting the allocation out of state treasuries- how can that be addressed?

5:39 p.m.: Comment From Murali

Is there a practical approach available to lower the possibilities of a donor donating during the window period? Like screening him twice in a regular interval, like waiting for say a 10 days before using that unit?

5:39 p.m.: Dr Shobini Rajan:

Yes, blood is to be used only when clearly indicated and benefits outweigh the risks.

5:40 p.m.: Dr Shobini Rajan:

@ Dr Rangarajan, yes a simple screening test can prevent Thal major.

5:40 p.m.: Vidya Krishnan:

Dr Rajan: is that followed though? How big is the problem of unnecessary procedures that Leena was talking about earlier?

5:41 p.m.: Comment From Dr. Rangarajan

@ vidya , convince the states its cheaper to prevent than to treat , -blood donors irrespective of previous status need to be checked for HCV, HIV and hep B .

5:41 p.m.: Chapal:

Entirely agree Dr Rangarajan

5:41 p.m.: Leena Menghaney:

also whole blood transfusions should be reduced and separating the blood products into red cells, platelets and transfusion according to a patients need should be the practice

5:42 p.m.: Comment From Ravi Shah

I would also use this opportunity to request-- Government and NGOs to fund and start BMT programs/research institutions across India so that Thalassemia, Aplastic anemia patients can be transplanted. --these patients require regular blood transfusions. Govt should subsidies or make free factor treatments for hemophilia. Laws should be enacted to make it mandatory for doctors to clearly write the indication of transfusion and to take written informed consent from patient.....

5:42 p.m.: Dr Shobini Rajan:

@ Murali, I would like to explain that once a unit is tested positive for any of the TTI, keeping it in quarantine is not going to change the status. It has to be discarded as per regulation. The window period can be detected only through retesting the donor, which is possible only in a scenario where majority of blood donors are regular and repeat.

5:42 p.m.: Comment From Dr. Rangarajan

No such tests exist in india for thal - thal minor can be diagnosed by screening FBE , i have diagnosed many thal patients in indian population in Australia

5:42 p.m.: Vidya Krishnan:

Dr rajan: are the feasible strategies to be implemented? Use of blood components instead of whole blood; reduction of unnecessary procedures and enlisting only regular donors- whose status is HIV known.

5:43 p.m.: Comment From Dr Shaik Nishan Ashraf

At best, the data published today must pave way for more studies to ascertain the risk of getting infected from a donor in window period. To say that blood is not screened would be a layman's prejudice.

5:43 p.m.: Vidya Krishnan:

Dr Rajan, has NACO's spending on IEC activities gone down in the past year? Secondly, how much emphasis is given by the ministry to ensure we have regular donors-- are there incentives?

5:44 p.m.: Leena Menghaney:

the medical community needs to address this issue of unethical practices where patients are transfused without actually needing it

5:44 p.m.: Leena Menghaney:

and this is huge in small towns

5:44 p.m.: Dr Shobini Rajan:

Vidya, yes you got it. Use blood rationally and in components. Govt has now also allowed for surplus plasma to be sent to fractionators for preparing blood products. VNRBD is the key

5:45 p.m.: Vidya Krishnan:

Leena: how can civil society help in ensuring blood safety programmes are implemented properly?

5:45 p.m.: Comment From Dr. Rangarajan

@ vidya ,et al - high risk groups need to be ear marked , truck drivers in India are a major risk group along with the sex workers and IVDUsers , their blood need to be double cheked and not used if for the first time meaning they need to be checked and left alone for 90 days and then checked again and if found negative then they can donate ( but even that does not detect those if infected in the interim )

5:45 p.m.: Chapal:

I think we have to also remember how incentivised it is to keep patients and to do transfusions. It's a process

5:45 p.m.: Dr Shobini Rajan:

Blood donors are regularly felicitated in events at national and state level on the occasion of World Blood Donor Day and National Voluntary blood donation day. There are tokens for appreciation, as the actual act of donation is voluntary and non remunerated

5:46 p.m.: Leena Menghaney:

On hemophilia some states have done good work but others need to address the needs of this vulnerable population

5:46 p.m.: Vidya Krishnan:

yeah.. it is tricky to incentivize this in monetary terms

5:47 p.m.: Dr Shobini Rajan:

Other Ministries can join hands by givign the donor some brownie incentives like privilege in availing benefits, some points for school admission of kids,. Rajasthan govt has recently given additional pouints for PG admission to blood donors.

5:47 p.m.: Comment From Dr. Rangarajan

ideally every one should insist that blood transfused in most instances should b from family members and that too checked , but unfortunately we do not live in ideal situations

5:47 p.m.: Vidya Krishnan:

Dr Rajan: So, in case a patient declares himself to have contracted HIV from the hospital, why doesnt the government follow up in great detail to ensure the claim is correct. Look at sexual history- drug usage etc..

5:48 p.m.: Dr Shobini Rajan:

@ Dr Rangarajan, Truck drivers and IDU do not qualify to be ideal blood donors. If a person gave such a history, he would be deferred as a donor.

5:48 p.m.: Vidya Krishnan:

@Dr Rajan: could the MOHFW take this idea forward? of incentivizing voluntary, regular donors in other ways... help with school admission etc

5:48 p.m.: Leena Menghaney:

actually its the opposite, most patients are unable to prove that they were infected with HIV, HBV or HCV from transfusions

5:49 p.m.: Comment From Ravi Shah

I disagree with Dr Rangrajan as transfusion from family members in some indications is not ideal. Because this can create antibodies to potential BMT donors!

5:49 p.m.: Vidya Krishnan:

Chapal/ Leena/ Dr Rajan: So, the burden of proof falls upon the patient? And the government cannot do anything about it?

5:50 p.m.: Dr Shobini Rajan:

I would tend to disagree that blood transfusion should be from related blood donors, as in India, we do not follow directed blood transfusions.

5:50 p.m.: Leena Menghaney:

my experience of working as a legal aid lawyer points to a very long drawn process to prove that they were infected by a transfusion

5:51 p.m.: Vidya Krishnan:

Also, how come some states do better while some- like UP in this case- fare so bad, year after year. It just points to systemic issues.

5:51 p.m.: Chapal:

No it doesn't. It's the job of the government national and state and of the medical community to ensure . At the same time, patients have to be provided relevant information. We don't seem to want to educate patients at all

5:51 p.m.: Comment From Dr. Rangarajan

well agreed , but how many would need BMT 's , are the numbers more than those needing Blood transfusions for surgeries and injuries , Ravi Shah

5:51 p.m.: Comment From Suresh

@Vidya, Blood Donation should be an voluntary act, and should not be based incentives. This would promote unethical practices and Donors who are not healthy/eligible would end up donating blood just for the sake of benefits!

5:51 p.m.: Comment From Dr. Harrys K.C. Jacob

It would definitely add on to people not taking blood from other non relatives or say castes

5:51 p.m.: Dr Shobini Rajan:

No, Vidya. HIV transfusion through blood is the only mode where the onus is not on the client, it is the system that needs further strengthening to reduce this figure to as close to nil as can be.

5:52 p.m.: Leena Menghaney:

yes this notion that blood from family is safe adds to the problem of patients receiving untested or inadequately tested blood

5:52 p.m.: Comment From Dr Shaik Nishan Ashraf

People can give incorrect histories. It is impossible to conclusively claim the route of infection. The onus of proof cannot be shifted either to the patient nor to the government.

5:52 p.m.: Comment From Ravi Shah

Agree..Infact this is common misconception in Indian people's mind!

5:52 p.m.: Leena Menghaney:

DR Shaik the burden is on the patient

5:53 p.m.: Comment From Ravi Shah

If patient gets infection after transfusion---proper procedure has to be in place to trace the donor and retest him and educate/treat him accordingly.....This is not to put blame on anyone but we can save much more future accidents---blood banks also will get idea regarding their quality testing etc

5:53 p.m.: Vidya Krishnan:

Leena/ Chapal/ Dr Rajan: The ministry data shows that some states do better while some- like UP in this case- fare so bad, year after year. It just points to systemic issues and blaming patients in certain states as resorting to lies to avoid the stigma

5:53 p.m.: Comment From Dr. Harrys K.C. Jacob

bloodbanks need to be stocked up and blood must be screened before transfusion which should be the call for the day!

5:53 p.m.: Leena Menghaney:

and most people leave it unchallenged as a legal battle may reveal their HIV+ status exposing them to stigma and discrimination

5:53 p.m.: Vidya Krishnan:

falls flat is we look at the data and inter state variations

5:54 p.m.: Vidya Krishnan:

@ Leena: Yes. extremely complicated but there have been a few cases where patients claimed compensation

5:54 p.m.: Vidya Krishnan:

I think we have time of final remarks on the subject.

5:54 p.m.: Chapal: The state variations are unavoidable. It depends on numerous factors including infrastructure funding leadership . This should however not be the case

5:54 p.m.: Comment From Ravi Shah

You can "up to some extent" rely on history from patient but still Proof of the Pudding lies in quality tests---We are still stuck with antibody testing which misses windove period--PCR testing is cheap now a days and I dont see any reason why cant be implemented for serious infections like HIV/Hep B????

5:55 p.m.: Leena Menghaney:

its not just blood transfusions. I have met patients with kidney disease who have been infected while on dialysis

5:55 p.m.: Vidya Krishnan: Dr Rajan/ Leena/ Chapal: Final remarks on the subject?

5:56 p.m.: Comment From Dr. Rangarajan

Maybe we need to start trialling artificial blood like in UK which is going to start next year or so

5:56 p.m.: Leena Menghaney:

India has a high burden of HIV, HBV and HCV and the blood safety programme should be supported in terms of better screening tools and funding and at the same time it should be held accountable for gaps such as the data on UP which is indicative of a problem

5:57 p.m.: Chapal: I think this data needs to be understood and contextualised. It may cause panic but hopefully this panic can be the starting point of discussion not just on the issue of transfusions and blood safety but a review of funding and strategy on HIv. There are multiple other aspects and finally the private sector which remain largely in unregulated

5:58 p.m.: Comment From Ravi Shah

Regulation of blood bank and blood product usage, Education of patients and public and improving curative treatment delivery to avoid transfusions!! Dr R Shah-

5:58 p.m.: Comment From Dr Shaik Nishan Ashraf

Strengthen the sentinel surveillence programmes.

5:58 p.m.: Comment From Dr. Rangarajan

targetted blood donations and education and spreading awareness to targetted groups ( low risk ) may be the answer , but even that needs testing

5:58 p.m.: Dr Shobini Rajan:

Blood Transfusion Services of India require to be strengthened to ensure standardized service delivery and the reliance of a safe unit of blood/ components to the user. The policy and regulation requires a closer tie up. REpeat blood donors further encouraged. Quality management systems and accreditation to be taken forward in blood banks.

5:59 p.m.: Vidya Krishnan: Thank you so much everyone for shining some light on this subject

5:59 p.m.: Vidya Krishnan:

Thanks for joining us for this chat.

6:00 p.m.: The Hindu:

And with that we bring this live chat to a close. Thank you for joining us, and a special thanks to our guests.


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