Related Experiment Videos
Transfusion transmitted diseases
1Transfusion Medicine Department, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Rae Barelly Road, Lucknow-226014, UP. nc@sgpgi.ac.in
Insights
Transfusion-transmitted diseases (TTDs) in India are a significant concern, with hepatitis B/C, HIV, and malaria posing major risks. Implementing sensitive screening and promoting voluntary donors can reduce TTD incidence.
Area of Science:
- Infectious Diseases
- Public Health
- Transfusion Medicine
Background:
- Transfusion-transmitted diseases (TTDs) represent a critical global challenge for blood transfusion services.
- In India, key TTD concerns include hepatitis B/C, HIV, malaria, syphilis, cytomegalovirus (CMV), parvovirus B-19, and bacterial infections.
- Hepatitis B and C carriers range from 1-5% and 1% respectively, with post-transfusion hepatitis B/C affecting approximately 10% of recipients due to low viremia and mutant strains.
Purpose of the Study:
- To assess the prevalence of various transfusion-transmitted diseases in the Indian blood donor population.
- To identify the major infectious agents posing risks in blood transfusions within India.
- To evaluate current strategies and propose improvements for reducing TTDs in India.
Main Methods:
- Review of existing data on the prevalence of infections like Hepatitis B/C, HIV, malaria, syphilis, CMV, parvovirus B-19, and bacterial infections among Indian blood donors.
- Analysis of factors contributing to post-transfusion infections, including low viremia, mutant strains, and screening test limitations.
- Consideration of the impact of donor types (voluntary vs. replacement) and laboratory testing sensitivity.
Main Results:
- Hepatitis B and C infections are prevalent, with significant rates of post-transfusion hepatitis B/C.
- HIV prevalence varies regionally, with some studies indicating lower rates than previously projected (e.g., 0.2/1000 in North India).
- High parvovirus B-19 prevalence (39.9%) poses risks to immunocompromised patients, while malaria screening remains challenging.
Conclusions:
- Reducing TTDs in India requires a multi-pronged approach, including enhanced vigilance and quality control.
- Promoting altruistic, repeat voluntary blood donors is crucial for improving blood safety.
- Adoption of sensitive laboratory testing methods is essential for minimizing transfusion-transmitted disease risks.
Abstract:
Transfusion transmitted disease (TTD) is a major challenge to the transfusion services all over the world. The problem of TTD is directly proportionate to the prevalence of the infection in the blood donor community. In India, hepatitis B/C, HIV, malaria, syphilis, cytomegalo virus, parvo-virus B-19 and bacterial infections are important causes of concern. Hepatitis B and C infections are prevalent in India and carrier rate is about 1-5% and 1%, respectively. Post transfusion hepatitis B/C is a major problem in India (about 10%) because of low viraemia and mutant strain undetectable by routine ELISA. HIV prevalence among blood donors is different in various parts of the country. It may not be so alarming as projected by some agencies. In one study from north India, confirmed HIV positivity was found in 0.2/1000 blood donor. Post transfusion CMV is difficult to prevent but use of leukocyte filters may help to reduce it significantly. Parvo virus B-19 infection in blood donors is 39.9% which may increase morbidity in multitransfused or immunocompromised patients. Current symphilis tests may not be sensitive but it should be continued to exclude high-risk donors. Malaria is a real problem for India due to the lack of a simple and sensitive screening test. Incidence of bacterial contamination is greatly reduced due to improved collection/preservation techniques and use of antibiotics in patients. However, proper vigilance and quality control is needed to prevent this problem. Total dependence of altruistic repeat voluntary donors and use of sensitive laboratory tests may help Indian blood transfusion services to reduce incidences of TTDs.