Thalassemia, a genetic blood ailment, is one of the most common blood disorders, especially in developing economies like India.

It is an inherited disorder characterized by defective hemoglobin synthesis and red blood cell (RBC) production, hence a thalassaemic patient would require lifelong blood transfusions.

With an estimated 42 million beta-thalassemia carriers and 10,000 new cases reported annually, India is home to one out of every eight sufferers.

The rate is also elevated in the child population. Among the 27 million births that occur annually, it is estimated that more than 10,000 children have thalassemia major, which is readily preventable.

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In Hyderabad, a 3-year-old thalassemic patient allegedly contracted HIV after receiving blood from the Indian Red Cross Society's blood bank /Centre (IRCS).

The boy underwent an HIV test in July and the results came back positive. Such instances are a call that we need to proactively raise our voices to strengthen the blood safety laws and regulations of our country.

This isn’t the first time such a case has taken place. In the last 3 months, we have had two cases including this.

Another case was in Nagpur where four children suffering from thalassemia were infected with HIV while undergoing blood transfusions.

This highlights the need for implementing better blood screening and testing standards across the country.

Patients with thalassemia who require regular blood transfusions are more susceptible to contracting new infections.

The sensitivity and specificity of NAT for viral nucleic acids shorten the infectious window period for HIV, HBV, and HCV.

Due to its higher sensitivity and capacity to shorten the window time, NAT is a suggested but optional test for screening for TTIs (for minimizing the remaining risk of infection), making transfusions safer.

Blood Centres should not replace the serology screening of TTIs with a different test, but rather use an additional test to increase patient safety.

The Nucleic Acid Amplification Test is an advanced platform for screening infectious illnesses. Here, the testing window is significantly shorter compared to other common systems.

Important for donor notification and counseling, NAT also resolves false reactive donations using serological tests.

Blood banks are free to implement whatever testing techniques they desire within the present system.

Based on the specialized tests or technology they apply; companies may charge a processing fee.

Therefore, it is essential to commission a study on best practices linked to blood safety, supporting a blood bank or blood banks in a specific region with NAT testing for the thalassaemic, and supporting technologies for assembling specialized pools of volunteer thalassemia donors.

As of now Rajasthan, UP, Uttarakhand, Jharkhand, and Karnataka have implemented NAT testing.

Other states need to share proposals with the center as part of their Programme Implementation Plan if they wish to inculcate NAT testing in their blood screening.

By Anubha Taneja Mukherjee

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