News

Need to further reduce risk of HIV transmission through blood transfusion in India: Experts

NEW DELHI: The risk of HIV transmission through blood transfusion in India has dipped over the years due to improved screening and testing protocols. However, the recent incident in which six children with thalassemia got infected with HIV once again exposes that the overall risk has still not been eliminated, said experts. On the eve of World AIDS Day on December 1, experts said the Jharkhand incident serves as a reminder that strict adherence to safety standards are vital to maintaining and further reducing HIV risk. Dr Ishwar Gilada, Secretary General, Peoples Health Organisation (India) and President Emeritus, AIDS Society of India, said, Children with Thalassaemia require multiple transfusions, almost 20-25 annually, making them statistically more susceptible to transfusion transmitted infections including HIV. According to Dr Sangeeta Pathak, Secretary General, Indian Society of Blood Transfusion, though the overall risk of HIV transmission through blood transfusion has generally decreased, the Jharkhand incident is concerning. There have been concerns and reports about recent cases where children with Thalassemia or other conditions received infected blood, highlighting that the risk, while low, is not eliminated. This serves as a reminder that ongoing improvements and strict adherence to safety standards are vital to maintaining and further reducing this risk, she told TNIE . Experts said that though the chance of catching HIV through blood transfusion is extremely low- about one in 1.5 million to 2 million transfusions, with less stringent screening, the risk may be higher. HIV transmission to Thalassemia children in Jharkhand exposes gaps in Indias blood banking system: Advocacy group Deepak Chopra, Mentor, Thalassemia Patients Advocacy Group (TPAG), said, The tragic case in Jharkhand, where children with thalassemia reportedly contracted HIV through blood transfusions, is not just a breach of protocol; it is a stark reminder of how preventable failures persist when governance weakens, and public health takes a backseat. Transfusion-transmitted infections remain a persistent threat, and continuing to rely on outdated screening methods is no longer acceptable, he added. Prof. NK Ganguly, former director general of the Indian Council of Medical Research (ICMR), stressed that safe blood is not a privilege; it is a right. Patients must be educated, empowered, and encouraged to demand it, systems must be equipped to deliver it, and policymakers must uphold transparency and accountability as non-negotiable pillars of blood service governance. He said the best way forward is to carry out public awareness campaigns to encourage voluntary donation while educating citizens about the risks of unsafe blood, the importance of advanced testing technologies like Nucleic Acid Testing (NAT) and their right to access blood that meets the highest safety standards. NAT enables the earliest detection of infections, including HIV, HBV (Hepatitis B Virus) and HCV (Hepatitis C Virus) and other transfusion-transmitted infections even during the window period, thus drastically reducing risk and creating a triple benefit that protects patients, empowers providers, and strengthens Indias public health and productivity, Prof. Ganguly told TNIE . Dr Gilada, who is a Governing Council Member and Focal Point for Asia-Pacific, International AIDS Society, explained that a wider window period up to 12 weeks with conventional HIV screening tests that are routinely used in blood banks allows some contaminated blood to be transfused. This isn't a human error but a policy and management issue, he said. Plan and start using NAAT-based HIV screening at all the blood banks. To reduce the cost per test, pooling of samples can be used with a pool of 5 or 10 samples, which can reduce cost by 75 to 90%, as our national HIV prevalence is still around 0.2%, he added. India's HIV prevalence has seen a decline from 0.33 % in 2010 to 0.20% in 2024 in India, as per government data. Chopra said what is equally critical is regulatory reform. India needs a unified national blood safety framework backed by enforceable standards, a centralised digital registry, and strict, meaningful audits. We must shift decisively from reaction to reform and ensure that every unit of blood transfused in this country is not only life-saving but life-affirming. The need of the hour is also to continue improving testing sensitivity, said Dr Pathak. NAT testing should be implemented to eliminate window period transmissions; pathogen inactivation techniques should be implemented for all blood products; voluntary, non-remunerated blood donation should beencouraged, alongwithmaintaining strict donor screening and deferral policies; and promoting awareness and testing among blood donors, she added. She further said that to prevent the repeat of Jharkhand-like incidents related to transfusion-transmitted infections like HIV, the government should take urgent and comprehensive actions. The most important is to strengthen blood safety protocols; investing in modern blood banks with state-of-the-art testing and pathogen reduction technology; ensuring proper storage, handling, and disposal of blood products; establishing an independent body to monitor blood safety practices; and regularly auditing blood banks and enforcing compliance with safety standards. Also, emphasis should be placed on providing ongoing training for healthcare workers and blood bank staff on the latest safety protocols and on developing protocols for the quick investigation and management of any suspected transfusion-related infections. As people with thalassemia are exposed to transfusion-transmitted infections,Dr Pathak said, the government should formulate policies that prioritise the safety of blood products for vulnerable groups like thalassemia patients. A specialised centre for thalassemia care with access to safe blood and comprehensive management is the need of the hour, along with the rollout of national registries for thalassemia patients to ensure they receive continuous, safe care. What is also needed is support to research into gene therapy and other curative approaches for thalassemia and developing and promoting affordable, safe alternatives to transfusions, Dr Pathak added. Jharkhand HC seeks info on demand, availability of blood in State hospitals after children test positive for HIV